affect every organ in the body. It can spread to the lungs, liver, brain…
and it causes a lot of infertility because over the years every time you
have your period, the endometriosis deposits within the pelvis also bleed.
The blood is an irritant inside the abdomen and so it causes a lot of
inflammation and when it settles down it results in healing with scarring.
TBWM: Okay, let us talk about the process and what
it entails for the couple who are considering IVF.
Dr DaCosta: When we see the couple we get
TBWM: Is the IVF procedure painful for the woman?
DrDaCosta: Not really painful. The egg
recovery is probably the most painful part, and women
with endometriosis usually feel a greater level of pain.
We usually manage the pain by giving adequate
medication to reduce the discomfort; but in most cases
the woman has little pain or no memory of pain, and we can understand
why, the joy of having a child outweighs the pain.
a good history, we examine and we do special
investigation to make sure there is no blockage of the
tubes. We do blood tests to check on the hormones to
make sure that the prolactin level is not too high and the thyroid is
working properly because all of this can affect fertility. We also check to
ascertain if eggs are being released because some women may be having
periods but not releasing an egg as in the case of a woman with
polycystic ovarian syndrome. Once we identify that there is a problem in
getting pregnant which will require IVF, the next step is to determine the
type of protocol we are going to put them on. We have different
protocols for different individuals, again depending on what we find in
the tests that we do. Then comes the counselling sessions, we teach the
women how to give themselves the injections. The injection is to done
to regulate their system, and pretty much shuts down their ovaries and so
all the eggs are pretty much at a starting point. We then add another drug
which is to stimulate the ovaries and allow the eggs to grow. We then
monitor the eggs via ultrasound and as soon as they are in the mature
range we give a third injection which is called HCG which triggers
ovulation. Thirty six hours after that we take the woman into the
operating theatre where we do a procedure to collect the eggs. The same
morning the partner gives us the sample of his sperm. Sometimes if there
is no sperm present