Experts continue to debate whether endometriosis increases the risk of miscarriage after you become pregnant. Many pregnancies end in miscarriage before women even realize they're pregnant. Sometimes a period that's especially heavy or arrives a day or two late is actually a very early miscarriage (sometimes called a chemical pregnancy).
Endometriosis may cause miscarriage by interfering with the chemical support necessary to maintain pregnancy by
^ Lowering progesterone levels or increasing prolactin levels.
1 Creating the immune issues that many women with endometriosis face.
Women who don't have endometriosis but do have an autoimmune disease (like lupus or rheumatoid arthritis) also have an increased risk of miscarriage and failed implantation. So, given the possible association of the immune system and endometriosis, it's understandable that women with endometrio-sis are also more likely to have a miscarriage.
Likewise, if you believe the molecular genetic explanation of endometriosis (see Chapter 4), then this defect may make it more difficult for an embryo to implant or continue to grow. These abnormalities can affect receptors and other factors that make implantation and continued development possible. The embryo and endometrium may not work well together. Either way, this defect can also explain the increased risk of miscarriage.
The following facts about miscarriage may surprise you:
^ More than 50 percent of all embryos stop growing before they develop a heartbeat.
^ One in four women has a miscarriage in her lifetime.
^ Eighty percent of miscarriages occur in the first 12 weeks of pregnancy.
^ A chromosomally abnormal embryo causes at least 50 percent of all miscarriages.
Of course, knowing these facts does nothing to ease the pain and heartache of miscarriage. Some studies have shown, however, that the treatment of endometriosis does reduce miscarriage rates in women with endometriosis.
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