News

10th World Congress of Endometriosis.

22 May 2008 10:00am

The World Congress, an important international event held only every two years, brings together the world’s leading researchers, scientists, surgeons and educators who are dedicated to the search for the ‘cure’ for this disease.

There are a variety of reasons why 1 in 6 Australian couples will have some trouble becoming pregnant. One common cause of infertility in women, accounting for almost 15% of the cases we see is the female medical condition endometriosis.

The key message from the conference was that surgery has become the gold standard treatment from advanced endometriosis.  The use of continual oral contraception has also been recognized bas valuable in improving pain and lifestyle.

The event reinforced that that it is important to INDIVIDUALISE EACH PATIENT'S TREATMENT DEPENDING UPON THE SEVERITY OF THE ENDOMETRIOSIS AND THE SYMPTOMS THAT SHE IS HAVING.

It is also important to assess the patient's level of symptoms, her demands for future children, as well as her social and occupational requirements. Good discussion with each patient, as well as the adequate provision of information is essential in this process.

Endometriosis is often a chronic disease and a good level of patient understanding is essential. Some patients with endometriosis will have increasing fertility problems. Fortunately, the results of assisted reproduction (such as IVF) after treatment for endometriosis are very good. Most patients with endometriosis, even if they have an initial problem with their fertility, end up becoming pregnant after adequate and carefully monitored treatment.

Whilst pregnancy is not a complete and definitive cure for endometriosis, the combination of pregnancy plus breastfeeding significantly slows down the course of the disease and, in fact, may get rid of it entirely.

Secondary Infertility

22 May 2008 10:00am

Secondary infertility is defined as the inability to become pregnant.  Following the birth of one or more normally conceived children. 

Even though they already have a child the couple sees secondary infertility as the loss of a child, a pregnancy, or a childbirth that they wished to have.

Despite the fact that secondary infertility is more common than primary infertility, affected couples are less likely to seek treatment for the condition.  After becoming pregnant with apparent ease many couples are caught completely by surprise when they have difficulty achieving a pregnancy again, assuming that past success guarantees future success.  Many medical practitioners underestimate the likelihood of infertility in previously fertile patients, simply advising them to keep trying.

Causes for secondary infertility include all those for primary infertility plus a few more:

The couple may always have been subfertile and the first child may have been sheer luck.
Consequences of the first birth could be making a contribution to the problem. 
In the intervening years all the common causes of infertility have had more time to develop. 
Finally there is the factor of age – the first child may have been conceived before the age of commencement of fertility decline but now the ageing egg factor is having an influence. 

Female age remains the most important reason to quickly acknowledge secondary infertility and seek treatment for it before chances diminish further.

Couples with secondary infertility are susceptible to feelings of self-blame.  They may regret not having been more proactive in having a family earlier, particularly if age is a factor in the secondary infertility.  The emotions of secondary infertility mirror those of primary infertility – a combination of anger, grief, depression, isolation, guilt, jealousy and self blame at loss of control of a life plan.  Complicating this is guilt and concern about how these feelings, and failure to produce a sibling, is and will affect the existing child.  Secondary infertility can destabilize the strongest of marriages and the counselling available as part of seeking diagnosis and treatment of the problem can be the key to resolution of the emotional side of the situation.

Unfortunately couples suffering secondary infertility receive less support from others than those with primary infertility.  Their infertility is far less obvious  and they frequently fail to acknowledge it to family and friends.  Those who do acknowledge it are frequently hurt by the unhelpful advice that they should be grateful for the child that they have.  While they inevitably are totally thankful, they still suffer the loss of the larger family that they desired.