This article was published in Scientific American’s former blog network and reflects the views of the author, not necessarily those of Scientific American
Infertility affects over seven million women, and one in eight couples, in the United States. Current testing options to determine the causes of infertility are very limited. In the absence of proper testing, couples may undergo fertility treatments that are ineffective. This can turn into an expensive, arduous process. Without understanding the root cause of infertility, treating it often becomes a guessing game. For doctors to effectively aid a couple along the path to conception, they need to understand every factor that is standing in their way. One factor that is notoriously difficult to diagnose is endometriosis, which affects one in 10 women. It is one of the most common causes of infertility, present in 30 percent to 50 percent of women who struggle with infertility.
THE STRUGGLES OF INFERTILITY
The inability to conceive can be devastating to couples. Many couples see it as a personal failure, not the unfortunate outcome of medical factors outside of their control. Part of that is because the standard of care in infertility does not adequately explain what is causing infertility and what can be done to combat those issues.
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Beyond the emotional scarring that struggling to conceive can cause, infertility can have a direct impact on the health of the baby once a woman is pregnant. Couples with infertility face a higher rate of miscarriages and stillbirths. There is also an alarming rate of birth defects and genetic problems in children that are born to an infertile couple.
Standard fertility tests do not assess all possible factors or adequately map out the best path to conception, and many of the options that women do have are incredibly expensive. On average, couples spend over $20,000 for a single IVF cycle and more often than not they have to undergo multiple IVF cycles. Even then, only about 35 percent of those women under the age of 35 will conceive. IVF can be so expensive and emotionally trying that most couples give up after an initial attempt.
ENDOMETRIOSIS: A COMMON CULPRIT
Endometriosis can be a debilitating disease that may be marked by painful periods, bleeding and pain during ovulation, uncomfortable intercourse, heavy bleeding and chronic pelvic pain. Some women have no symptoms. The disease may impact fertility in several different ways, the most significant being scar tissue and adhesions marring the fallopian tubes and uterus, making the uterus inhospitable and damaging egg quality. Endometriosis is probably several different diseases with multiple causal factors, and some women have a form of endometriosis that has no impact on fertility.
The most alarming part of this disease is that there is an average delay of four to 11 years from the onset of symptoms to diagnosis.Women who are unaware of their diagnosis can do nothing to treat it. In that time, the symptoms worsen and compound, exacerbating the pain and further impacting fertility. A primary reason for this delay is the need to be diagnosed through an invasive laparoscopy, a surgical procedure performed in the abdomen or pelvis. As such, women often simply live with the pain, attributing it to “normal” period cramps.
THE NEED FOR NONINVASIVE INFERTILITY TESTING
Noninvasive testing to diagnose endometriosis and other factors of infertility would allow and empower women to learn of their disease earlier, take the necessary steps to manage it and protect their fertility before it is irreparably harmed. Early diagnosis can improve not only patients’ physical health but also their mental and emotional wellbeing. Through more advanced genetic diagnostics, couples may achieve pregnancy more easily and produce healthier children. Noninvasive and effective diagnostic tools—such as ARTguide
, for example, a blood test that tests for genetic factors of infertility including endometriosis and ovulation issues—could allow for a deeper level of understanding around the challenge of conception.
There needs to be a focus on genetic factors because they have a big impact on individual health and infertility. If doctors can use a noninvasive diagnostic tool to determine if their patients have endometriosis or other genetic factors of infertility, doctors will be able to use that knowledge to alter fertility care to create a custom treatment plan that may work better and decrease the cost of care.
Most young couples who are trying to conceive are information seekers, especially in today’s era of patient advocacy. They want to have the most up-to-date information available and know as much as they can about what is affecting their path to conception. Unfortunately, standard tools can be decades behind current science. There are incredible resources in genetics that are not being tapped into by standard of care.
Endometriosis can have lifelong implications for women, and the current standard approaches are simply not enough. Technology is advancing at an unprecedented rate, and in order to give patients the best possible care, doctors need to tap into the latest tools. For infertility and endometriosis, that means an earlier diagnosis to understand all of the factors that are impacting the patient. When it comes to something as personal as the ability to conceive a child, patients deserve the most advanced and personalized options.