I just watched a lecture by an Endometriosis fertility expert. She presented a study showing that the biggest cause of infertility & miscarriage in people with endometriosis is because it causes systemic inflammation, which causes epigenetic changes to the BCL6 gene.

This gene controls which estrogen receptors are active in the endometrium (uterine lining). If you have the abnormal BCL6 gene expression, then the cells in your uterine lining switch to an abnormal estrogen receptor, which then blocks the cells from receiving progesterone.

It's necessary to have progesterone in the cells of the uterine lining in order for embryos to be able to implant in the lining & to prevent miscarriage. Basically what this means is that you could have the exact same blood levels of fertility hormones including progesterone as someone who doesn't have endometriosis, yet you could have far less progesterone in the actual cells of the uterine lining because it's being blocked.

The epigenetic changes can be tested by having an endometrial biopsy done. It's not a fun procedure to have... but if your regular fertility hormone test comes back normal, then this is the next step. People undergoing IVF who have endometriosis often get it done to make sure the embryos are going to be able to implant before transferring them, so the embryos aren't wasted.

For people who do have abnormal BCL6, a very thorough exision surgery with a highly skilled endometriosis specialist can normalize expression & progesterone levels in the uterine lining within 3-4 months after surgery. You can find excision surgeons in the Facebook group Nancy's Nook Endometriosis Education. For those who have abnormal expression but are only stage 1 or 2 endo & don't have enough pain to justify surgery, then a long course of lupron is beneficial (up to 6 months) to help gene expression normalize.

But this can only be done if there is adequate ovarian reserve since long term lupron can sometimes reduce ovarian reserve. I suggest copying & pasting all of this into a word document to refer back to later & take to discuss with your OBGYN & a reproductive endocrinologist (fertility specialist) if you're able to see one. Reproductive endocrinologists will also have tighter optimal ranges for hormones, they test more of them (like a full thyroid panel) & be much more knowledgeable & better at treating infertility than a regular OBGYN. Here's info on the test:

https://receptivadx.com/women-families/about-re...

@A MyEndometriosisTeam Member - Sure thing! I took notes from that lecture since after my exision & fibroid removal surgery I'm going to be doing egg retrieval, freezing embryos for later & possibly doing IVF. Gotta make sure it's successful & worth going through all of that!

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A MyEndom...

Wow! Thanks so much for sharing ♥️‼️