If pregnancy does not come spontaneously, what alternatives are offered to these women suffering from endometriosis? Should they have their eggs vitrified? Dr Érick Petit, doctor specializing in endometriosis, tells us everything.
- To do a fertility assessment, you must first have tried to get pregnant naturally for a year, with frequent spontaneous intercourse (at least 3 per week).
- A complete fertility assessment allows you to confirm the diagnosis of infertility and find the cause of this infertility. “We must also not forget a spouse’s assessment, we must do a spermogram study,” adds the doctor.
- For patients with severe endometriosis, who want to have a child one day, but currently have no short-term plans, the specialist advises them to freeze their eggs before the age of 35.
Whether or not she suffers from endometriosis, when a woman presents subfertility, it is after one year that she can request medical assistance for procreation. “After a year of trying with frequent spontaneous reports, that is to say at least 3 per week, which do not result in a pregnancy, we must begin to carry out investigations.”, explains Dr. Érick Petit, president of RESENDO, endometriosis city hospital network.
IVF: “this is the reference technique for endometriosis”
A complete fertility assessment allows you to confirm the diagnosis of infertility and find the cause of this infertility. “We must also not forget a spouse’s assessment, we must carry out a spermogram study”, adds the doctor.
For women, the examinations are diverse. “If we see that the tubes are not dilated on the usual imaging tests, which are endovaginal pelvic ultrasound and MRI, we do a hysterosalpingography, a classic radiological examination to check if the tubes are permeable. Once this has been done, the woman is most often suggested to do what is called in vitro fertilization: this is the reference technique for endometriosis, possibly associated with ICSI. [Injection Intracytoplasmique de spermatozoïde, ndlr] when there are previously authenticated spermogram problems.”
In certain cases, when the patient presents too intense pain which does not allow her to have sexual intercourse, it is possible to operate. “It is done less and less, but it is sometimes necessary to operate on certain patients who have more severe forms anatomically and are very disabling in terms of pain.”, and for which medical and paramedical care is not sufficient.
Vitrification of oocytes: “it must be done before the age of 37”
The doctor also wishes to remind women wishing to have a child that, after the age of 35, the ovarian follicular reserve decreases regularly. “So in patients with endometriosis, especially if it is severe, there have already been several operations, or there are bilateral ovarian crystals, who are around their thirties and who do not have a partner , we can do what we call fertility preservation. It’s important, it’s a kind of all-risk insurance. The eggs are collected and frozen so that there are at least 15.” To achieve this minimum number, it sometimes takes two to three stimulation sessions.
“This should ideally be done before the age of 35, and there is a long waiting list to register in approved PMA centers. In Île-de-France for example, it is already around two years…. So you should not delay too much because it is imperative to do it before the age of 37.”
The full interview with Dr Érick Petit in Question aux Experts can be found on our YouTube channel:
