Endometriosis risk


You have an increased risk of endometriosis

Here is what you need to know:

Endometriosis is a chronic, systemic, autoimmune disease. Your immune system is deregulated and confused. This causes abnormal secretion of inflammatory cytokines in the peritoneal cavity (abdominal cavity), which initiate the transformation of the peritoneal cells to endometrial cells. The excessively inflammatory environment has the following effects on reproduction:

(1) development of scar tissue that obstructs the Fallopian tubes,

(2) excessive inflammation of the ovaries causes oxidative stress and reduction of the ovarian reserve leading to infertility,

(3) development of endometrial tissues in various organs, including the urinary bladder, intestine, ureters, and even the abdominal diaphragm,

(4) inflammation of the endometrial cavity causes recurrent implantation failure and miscarriages.

Clinical Presentation:

Most patients with endometriosis do not have any symptoms except for infertility. This is the main reason we fail to diagnose endometriosis so frequently. One in every three women who seek infertility treatments suffers from undiagnosed endometriosis. Every woman failing IVF with a high-quality embryo has a 50% risk of suffering from undiagnosed endometriosis. Every woman failing two or more IVF procedures with high-quality embryos has an 80% risk of suffering from undiagnosed endometriosis.

Diagnostic testing:

Receptiva, a test requiring an endometrial biopsy, measures the endometrial levels of BCL-6, a protein highly connected to endometriosis in the abdomen. An abnormally high BCL-6 result is associated with a 94% risk of endometriosis. Therefore, patients with infertility should have an endometrial biopsy for BCL-6 to rule out endometriosis before they waste their embryos. Further, endometriosis causes low quality and low numbers of eggs, and all patients with low ovarian reserve should be examined for endometriosis. The best way to diagnose and, at the same time, treat endometriosis is using laparoscopy, an outpatient procedure.

Improper testing fails to diagnose endometriosis:

A major problem I have noticed with most fertility experts is combining an endometrial biopsy for ERA with a biopsy for Receptiva. This makes sense to save money and pain for the patient, but ERA is usually done on a medicated cycle to examine endometrial receptivity. This is a problem for BCL-6 because the hormones used for the medical cycle cause a high rate of false negative BCL-6 tests. This is one of the reasons why we fail to diagnose endometriosis is not diagnosed. Endometrial biopsy for Receptiva and BCL-6 testing should only be done on a natural menstrual cycle, even if this forces the doctor to do two biopsies.

Ovarian rejuvenation:

Patients with suspected or confirmed diagnoses should be started on specialty supplements and medications to rejuvenate the ovaries and improve their eggs’ number and quality before attempting another egg retrieval. This is essential, but most fertility experts would rather proceed with one or more retrievals than do the correct thing. Banking of embryos in patients with endometriosis that was not appropriately treated will only create defective and poor-quality embryos that will fail to implant or end up in miscarriage.

What you need to do:

Talk to your obstetrician/gynecologist or infertility specialist to rule out endometriosis the right way and not cut corners or dismiss the effects of endometriosis. Many fertility doctors use Lupron, believing this will suppress any endometriosis. This is a fallacy and lousy medicine to use such a strong medication without a diagnosis. Lupron causes osteoporosis, and we should not use it lightly; in addition, Lupron does not help patients with undiagnosed endometriosis. I have seen this failure in hundreds of my patients coming to me because of “unexplained” infertility. If your doctor does not understand this, please, call my office for a consultation, virtual or physical. If you wish, we can order our recommended customized supplement protocols for your fertility needs and help you improve your egg number and quality.