Patient's question:
Hello doctor!I have uterine prolapse. Will this prevent me from getting pregnant? What can I do to get pregnant? Thank you!
Doctor's answer:
Hello: The normal infertility rate in women is about 15%, while it can be as high as 40% in patients with endometriosis. The reasons for infertility in severe endometriosis patients may be related to extensive adhesions of pelvic organs and tissues and weakened peristalsis of fallopian tubes, which affect the release of oocytes, their uptake, and the transport of fertilized eggs. However, mild patients with no obvious pelvic anatomical abnormalities may also suffer from infertility. The cause of infertility is not solely due to local anatomical abnormalities. It is now widely believed that infertility in patients with endometriosis may also be related to the following factors:1) Luteal phase deficiency: Endometriosis patients have fewer LH receptors on their follicles and luteal cells compared to normal women, leading to insufficient luteal secretion during the luteal phase and affecting conception.
2) Luteinized unruptured follicle syndrome (LUFS): This condition is characterized by ovulatory failure, where the follicle luteinizes but does not rupture. Although the patient's temperature shows a biphasic pattern and the endometrium appears in the secretory phase, pregnancy is not possible. The diagnosis is based on laparoscopic examination: in the expected ovulation period, there is no ovulation pore on the surface of the ovary 4–10 days after ovulation; the follicle continues to grow 2 days after the LH peak; and there is no sudden increase in estrogen and progesterone levels in the abdominal fluid during the menstrual cycle. Studies have confirmed that the incidence of LUFS in endometriosis patients is significantly higher than in normal women, leading to infertility. Konincks proposed that due to the presence of LUFS, the levels of estrogen and progesterone in the abdominal fluid are low, failing to suppress the implantation of endometrial cells that reflux into the abdomen, thus causing pelvic endometriosis. He believed that LUFS is the root cause of endometriosis. However, this theory has not been widely accepted.