Infertility And Endometriosis - Endometriosis and Immune-Related Miscarriage

Infertility And Endometriosis - Endometriosis and Immune-Related Miscarriage

Whether or not to have surgery to correct endometriosis before IVF treatment is a question many women are asking. The answer is a controversial one based on what stage of endometriosis you have, and is recommended on a case-by-case basis.  Dr. Seckin recommends that patients that have debilitating symptoms of endometriosis, and whose quality of life is severely impacted to have surgical intervention.  The excision surgery, which is the “gold standard”  for removal of the affected tissues is most effective in making sure that no disease is left behind. This increases the likelihood of conceiving and carrying a pregnancy to term in all stages, particularly, in the advance stages of endometriosis.

Dr. Seckin also recommends consulting with an IVF specialist prior to any endometriosis surgery.The knowledge and experience of your reproductive specialist is imperative to successful IVF treatment.  Not all IVF specialists recognize the impact of endometriosis on infertility or look as closely at the immune component on miscarriage as Dr. Jeffrey Braverman of Braverman IVF & Reproductive Immunology. Dr. Seckin recognizes Dr. Braverman as the only specialist who performs extensive blood tests in search of the inflammatory and immune component of infertility and miscarriages due to endometriosis. Below is a guest blog from Dr. Jeffrey Braverman on infertility and miscarriage as it relates to endometriosis. 

Endometriosis and Immune Related Miscarriage

Endometriosis is a potentially debilitating condition affecting a high percentage of women of reproductive age that can cause pain, irregular bleeding, infertility and recurrent miscarriage.  Endometriosis occurs when endometrial tissue, which normally lines the inside of the uterus (eutopic endometrium), inappropriately establishes growths in other areas of the body (endometriotic lesions). Endometriotic lesions are typically established in the abdominal cavity and are thought to occur in part through retrograde menstruation, a process in which sloughed eutopic endometrium enters the abdominal cavity through the fallopian tubes.     

Infertility and miscarriage related to endometriosis is multifactorial, involving impaired folliculogenesis, impaired ovulation, luteal defects and compromised oocyte quality. It is now also known that embryo implantation into the eutopic endometrium is impaired in women with endometriosis. A great deal of research on implantation failure related to endometriosis has revealed reduced endometrial receptivity due to aberrant expression of adhesion molecules, such as integrins, that are involved in binding to the embryo. Reduced expression of these adhesion molecules in endometriosis appears to be related to resistance of the eutopic endometrium to the effects of progesterone – a phenomenon known as “progesterone resistance."

Endometriosis is also characterized as an inflammatory disorder that involves elevated levels of inflammatory mediators (cytokines) and multiple changes in the function of immune-system components including macrophages, NK cells, T cells and B cells. Newer research has now started to explore the potential contributions of these immune-system changes to altered function of the eutopic endometrium. This research has identified, amongst other things, changes in the numbers and function of dendritic cells and regulatory T cells (Tregs) in the eutopic endometrium of endometriosis patients. Additionally, endometriosis is associated with activation of B cells and their production of autoantibodies that bind to molecules in eutopic endometrium (anti-endometrial antibodies). Several of these antibodies, including anti-laminin-1 antibodies, have been found to be associated with infertility and recurrent miscarriage in endometriosis patients.    

At Braverman IVF & Reproductive Immunology we are currently developing tests based on these alterations in eutopic endometrium and immune system function in endometriosis patients to help identify those patients at increased risk for infertility, implantation failure and recurrent miscarriage. These tests will detect specific cellular and molecular defects present in patients with endometriosis that will allow us to further personalize and tailor our treatment protocols for these patients. 

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Patient Reviews

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  • Megan Rafael Moreno

    I was in pain for 2 years. I was getting no answers, and because dr Goldstein and dr seckins were willing to see and treat me I'm finally feeling almost back to normal. They were very down to earth and helpful in my time of need. Dr Goldstein was easy to talk to and caring, she took care of me…

  • Nancy Costa

    Dr. Seckin is one of the best endometriosis surgeon. Every time I go to the office, he really listens to me and is always concerned about my issues. Dr Seckin's office staff are a delight and they always work with me. I feel I can leave everything to them and they will take care of it. Thank you to the…

  • Rebecca Black

    Fast forward 5 years to find out incidentally I had a failing kidney. My left kidney was only functioning at 18%. During this time, I was preparing all my documents to send to Dr. Seckin to review. However, with this new information I put everything on hold and went to a urologist. After a few months, no one could figure…

  • Monique Roberts

    I'll never stop praising Dr. Seckin and his team. He literally gave me back my life.

  • Erin Brehm

    I had a wonderful experience working with Dr. Seckin and his team before, during and after my surgery. I came to Dr. Seckin having already had laparoscopic surgery for endometriosis 5 years prior, with a different surgeon. My symptoms and pain had returned, making my life truly challenging and my menstrual cycle unbearable. Dr. Seckin was quick to validate my…

  • Anita Schillhorn

    I came to Dr. Seckin after years of dealing with endometriosis and doctors who didn't fully understand the disease. He quickly ascertained what needed to be done, laid out the options along with his recommendation and gave me the time to make the right decision for me. My surgery went without a hitch and I'm healing very well. He and…

  • Nicholette Sadé

    Dr. Seckin brought me back to life! I am now 3 weeks into my recovery after my laparoscopy surgery, and I feel like a new and improved woman! Being diagnosed with Endometriosis, then 25yrs old in 2015, and discovering the severity of my case being stage 4, made me devastated. Dr. Seckin's vast knowledge of the disease, sincere empathy, and…

  • Jason Curry

    My wife had her laparoscopic excision surgery to remove endometriosis with Dr. Seckin on Jan 30, 2014. She doesn't write online reviews so I'm writing this on her behalf. I accompanied her with each office visit she had. The staff--Lucy and Kim, are very friendly, warm and professional. Dr. Seckin was excellent in every capacity. He spent a lot of…

  • Liz Filippelli

    He is an awesome doctor who saved my daughters life from debilitating endometriosis..she knew instantly upon awaking from surgery that she was better..that wad May and no complaints only praises for Dr. Wonderful Seckin!!

  • Karen N

    I was diagnosed with Endometriosis at 19. I saw several Endometriosis "Specialists" since then, had a few laproscopic surgeries to "remove" the endometriosis and continued to be in pain. I had a hysterectomy in 2012 and was told this would stop the pain once and for all. No such luck! Tired of spending days in bed with a heating pad,…

  • Lauren Rodriguez

    I researched and found Dr. Seckin after dealing with years of doctors who couldn't help me or refused to go the extra mile for their patients. I have to say I am truly blessed to have found such a compassionate and talented doctor. He is exquisite with everything he does, and both his team at the office and surgical team…

  • Kellya Vespa

    Dr. Seckin is a very skilled surgeon. There are not many doctors like him that truly understand the effects of endometriosis. I am lucky to have found him. The staff is wonderful too.

  • Meg Connolly

    Dr. Seckin truly LOVES what he does and cares about his patients from the bottom of his heart. My life has already changed in 3 weeks and I couldn’t be more grateful. Should I ever need another operation for endometriosis, Dr. Seckin will be the one to do it. I recommend him to anyone I come across with similar problems…

  • Elisandra O

    Dr. Seckin is an amazing Doctor he is very compassionate, caring and he will be honest with you. He's been my doctor for 19yrs and I am so grateful to have someone taking care of me that knows what he is doing and knows the best way to treat each and every situation. I would definitely recommend him and his…