Wendy’s Story: Wendy, a thirty-one-year-old manager of a Florida boutique, has been married for three years. She has been trying to get pregnant but has encountered many difficulties. Wendy described her crisis: ‘After doing a laparoscopy on me, my doctor told me 1 didn’t have endometriosis. He said I was okay, yet I’m in pain two weeks of every month. I want a baby, but its hard to fed sexy when you feel so bad. Even so, I’ve been pregnant three times in the last two and a half years, but I have miscarried each one. What could be wrong with me?”

Wendy’s plight is one many women with undiagnosed endometriosis understand all too well: pain, infertility, and no adequate explanation tor their symptoms. In the past, it was felt that endometriosis in a more advanced stage prevented pregnancy because cysts and massive adhesions set up a hostile environment for conception. Most recent research into the subject, however, has revealed that a one-to-one correlation between infertility and endometriosis exists at earlier stages, too. (A chapter devoted to this will explicate further.) This research on earlier-stage endometriosis is particularly relevant to Wendy’s case.

A team of doctors at the University of Kentucky Medical Center’s Reproductive Endocrinology Department in Lexington concluded, in their 1985 study, that women with mild endometriosis suffered twice the number of spontaneous abortions, or miscarriage, that women with the disease at a more serious stage suffered. In examining this phenomenon, Michael Vernon, Ph.D., and his colleagues speculated that early or milder endometriotic lesions might be more “metabolically active” and produce prostaglandins, the hormones that have been implicated in the activity of endometriotic tissue. Prostaglandins might be partially responsible for infertility and miscarriage, since they cause uterine and tubal cramping, thus making conception and full-term pregnancy more difficult.

In further testing, they examined various types of implants, from very mild to serious. These implants have, in fact, been classified on a rating system to standardize their description for doctors. Devised by the American Fertility Society this system charts and describes implants by color and degree of growth, and rates them on a scale of severity from I to IV. (See the illustration on page 66.) Implants may be red, reddish brown, dark brown, or black (also known as powder bum). The Kentucky team also discovered that the “mildest” implants produced and synthesized twice the amount of prostaglandin F that implants at an intermediary stage produced, which in turn produced more of the hormone than the powder-bum variety, (In some expertments, powder-burn implants produced no such hormone.) This explains why women with minimal endometriosis sometimes experience more pain than women with massive growths. (Massive growths arc simply easier to identify.)

Wendy’s doctor clearly suspected endometriosis—no doubt this reason for performing a laparoscopy. That he was unable to find any obvious trace of the disease led to his conclusion that she was free of it. My advice to Wendy is to return to her doctor to begin a program of Danocrine to halt endometriotic growth, and to start on a diet high in complex carbohydrates and rich in B vitamins—the vitamins that are important in combating stress and favoring conception.

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