Presenter Sabrina Sato’s pregnancy once again drew attention to an issue that accompanies many Brazilian women diagnosed with endometriosis: the possibility of getting pregnant after the age of 40. Although the disease is one of the main causes of female infertility, it does not prevent pregnancy. However, the combination of advanced age and endometriosis requires even more careful planning and medical monitoring.

The gynecologist and obstetrician specializing in endometriosis Dr. César Patez, from Espírito Santo, and the gynecologist and obstetrician Dr. Paulo Noronha, from São Paulo, explain the main points about endometriosis and late pregnancy. Check it out!

1. Endometriosis does not mean pregnancy is impossible

Receiving a diagnosis of the disease tends to generate insecurity, especially among women who still want to have children. However, the infertility It does not happen in all cases and depends on the stage of endometriosis and the involvement of the reproductive organs.

“Endometriosis can reduce fertility, but it does not prevent all women from getting pregnant. Many achieve pregnancy spontaneously, while others need specific treatments. Today we have resources capable of preserving fertility and significantly increasing the chances of pregnancy when there is adequate planning”, explains Dr. César Patez.

2. After the age of 40, age becomes as important a factor as the disease

Even in women without endometriosis, fertility naturally declines over the years. When both factors are present, monitoring needs to be even more individualized. “After the age of 40, there is a significant drop in ovarian reserve. When the patient also has endometriosis, we carefully evaluate the clinical history, exams and general health conditions even before pregnancy. Each case requires a different strategy to ensure greater safety”, explains Dr. Paulo Noronha.

3. Pregnancy may be considered higher risk, but that does not mean there will be complications

the term “risk pregnancy” It tends to scare many women. However, in practice, it only indicates that the patient will need closer prenatal care. “Advanced maternal age increases the chance of some complications, such as hypertension, gestational diabetes and premature birth. This does not mean that they will happen. The objective of prenatal care is precisely to identify any changes early and conduct the pregnancy safely for mother and baby”, highlights Dr. César Patez. According to him, current medicine allows monitoring these patients in a very efficient way.

4. Pregnancy often alleviates the symptoms of endometriosis, but does not cure the disease

Many women report significant improvement in pain related to endometriosis during pregnancy. However, this happens because of the hormonal changes typical of this period. “During pregnancy, the patient stops menstruating and this temporarily reduces the activity of endometriosis, providing relief from symptoms. However, the lesions remain present and can cause pain again after childbirth, when menstrual cycles return”, explains Dr. Paulo Noronha. Therefore, it is important not to create false expectations regarding the disease.

5. Pregnancy planning makes all the difference

Women with endometriosis who wish to become pregnant should seek medical advice before discontinuing contraceptive methods. According to Dr. César Patez, this allows us to evaluate the ovarian reserve and define the best strategy for each patient.

“Planning pregnancy makes it possible to identify possible difficulties before they happen. In some cases, we only recommend monitoring; in others, specific treatments or assisted reproduction techniques. The sooner the patient seeks help, the greater the chances of success”, he states.

6. Each case of endometriosis is different

Not every patient has the same severity of the disease, which explains why some get pregnant quickly while others face difficulties. According to Dr. Paulo Noronha, individualization is one of the pillars of endometriosis treatment.

“The location of the lesions, previous surgeries, involvement of the ovaries and the time of evolution of the disease completely change the management of the case. There is no single rule for all women with endometriosis”, he highlights.

Doctors emphasize that medicine has evolved a lot in recent decades, both in the treatment of endometriosis and in assisted reproduction. In Dr. César Patez’s opinion, stories like Sabrina Sato’s help break one of the main myths about the disease: the impossibility of pregnancy.

“Motherhood continues to be a reality for many women with endometriosis, even after the age of 40. The most important thing is to seek specialized support, avoid self-diagnosis and understand that each patient has a different path to pregnancy. Today we are able to offer much more effective treatments than a few years ago”, he concludes.

By Sarah Carvalho