Endometriosis: A Key to Healing Through Nutrition. Michael Vernon

from observation, women who have ovarian cysts should have them removed before undergoing ART (assisted reproductive technology). The quality of the ova is poor if ‘chocolate’ cysts are present and improves after they have been removed. More research is needed to look at this phenomenon. But it implies that women with endometriosis stand a better chance with ART techniques when their health has been improved.

      Also, at the stage of conception, it is vital that the immune system does not react to the presence of the blastocyst. Normally, increased levels of progesterone from the corpus luteum quieten the immune system. Sperm appear in the Fallopian tubes 5–10 minutes after coitus, although some may take 48 hours. An organ on the head of the sperm releases enzymes which penetrate the ovum. If the woman’s immune system is overactive at this time, both the sperm and blastocyst could be harmed.¹⁶

      EARLY MISCARRIAGE

      The most common time for a miscarriage to occur is during the first three months (trimester) of pregnancy. At this time, the embryo is developing into a fetus and is undergoing truly amazing and dramatic changes, including the formation of most of its internal organs. This is a critical period of development that requires an appropriate nutrient-rich environment, a healthy placenta and a very delicate balance between the various hormones of pregnancy. It has been suggested that women with endometriosis have a greater chance of miscarriage than women with other types of reproductive dysfunction: ‘Miscarriage rates as high as 46 per cent have been reported in the scientific literature’.¹⁷ This area is currently being examined by other researchers who have not seen as dramatic an increase in the miscarriage rate of endometriosis patients.¹⁸ A high miscarriage rate among women with endometriosis would offer another explanation for endometriosis-associated subfertility.

      Human reproduction is inefficient, with an estimated 50 per cent of conceptions failing, and 10–12 per cent of pregnancies ending within 12–14 weeks after the last menses. Many are associated with antiphospholipid antibodies, placental insufficiency, impaired fetal growth or fetal distress.¹⁹

      However, the real enigma of a first trimester miscarriage is that if it occurs during the first six weeks of the pregnancy, there is a good chance that you may not even be aware that you are pregnant. You may think your period is late. It is very difficult to determine pregnancy rates in normal healthy women and in endometriosis patients. In fact, this lack of pregnancy information is one of the main reasons for the confusion in the scientific literature.

      Regardless of whether or not there is a high miscarriage rate in endometriosis patients, it is imperative that you eat the right sort of nutrient-rich foods to try to ensure the maintenance of your pregnancy. Nutrition in both parents even before pregnancy has a profound effect on the state of the egg and sperm, as well as on the nature of the secretions within the peritoneal cavity. Your choice of foods, particularly fats and oils, may be a crucial factor as these affect the production of prostaglandins, cell membranes, steroid hormones, and neurotransmitters etc. (see chapter 4).

      Thus, there are many reproductive problems associated with endometriosis, and scientific investigations have yet to determine exactly how endometriosis causes infertility. However, 40–60 per cent of women with endometriosis do appear to become pregnant. There are many positive ways that we can successfully attempt to correct the problem of infertility.

      FERTILITY AND THE ALERT IMMUNE SYSTEM

      ‘The leading question we should be asking here is whether or not the presence of antibodies can cause infertility and early miscarriage, by interfering with implantation.’²⁰ Reproductive tissues contain large numbers of immune cells and produce large amounts of cytokines, which are implicated in the fertilization process. Chapter 9 explains this in more detail.

      To achieve pregnancy, sperm has to enter the body. The sperm can be judged as ‘alien’ by a woman’s immune cells, because it is ‘non-self’. If pregnancy is achieved, the woman’s immune system has to adapt to the presence of ‘alien’ tissues growing inside her for nine months. However, there must be some mechanism which tells the female immune system that this alien tissue is not a danger to avoid damage to the embryo. Perhaps when the immune system is malfunctioning in endometriosis, this mechanism fails and causes an immune attack on the embryo and sperm, thus leading to infertility. Correcting or strengthening the immune system may help to achieve fertility. Healthy ovaries which produce the right amounts of progesterone are crucial in this process as progesterone dampens down a woman’s immune system.

      Scientists at University College London have discovered a protein (iscollin) inside sperm which is released as egg and sperm fuse, and starts a chain reaction that causes the embryo to form. Chemical interactions trigger calcium deposits inside the egg to vibrate and begin the cell-splitting process that leads to formation of the embryo. Defective sperm or eggs could not begin this chain reaction. This exciting area may lead to more research into egg quality in women with endometriosis.²¹

      YOUR FERTILITY: NUTRITIONAL EFFECTS

      Healthy parents usually have healthy babies. Once conception has happened, there is no changing what will be. We think of conception as the beginning of life, the time when sperm and egg collide and the magic of life begins. However, the egg and the sperm are not made in an instant; the parents’ bodies have been working hard to prepare them for the previous three months. Women are born with all their eggs ready and waiting inside their ovaries (see here.). At birth, female babies have around one million eggs, but by puberty, only about 400,000 are still viable. Each month, five to ten eggs begin to ripen, but only two or three fully mature. Over the normal 28-day menstrual cycle, the mature eggs ‘pop’ out at ovulation and are sucked up by the Fallopian tubes to begin their journey to reach a healthy sperm. The ripening of the egg is supported by the mother-to-be eating a diet rich in essential nutrients.

      Many ethnic groups have a period of time when a new bride is well fed before becoming pregnant; an early study on nutrition mentions how ‘the Masai tribe had specific times for marriage to ensure that the bride had a few months on a nutritious diet’.²² Even Queen Esther in the Bible had a special diet for a year before her wedding.²³ Leah became pregnant after eating mandrakes, which were believed to promote fertility.²⁴ In the book of Judges, an angel gave preconceptual advice to Samson’s mother: ‘Take care not to drink any wine or beer, or eat any forbidden food’.²⁵

      If the mother has a poor diet, consisting of highly refined foods, containing excessive sugar, fat and processed carbohydrates, the amount of nutrients available to the developing egg, or embryo, will be low. Poor nutrition at this time may lead to miscarriage.

      Think of the womb lining as a nest. Birds build their nests to keep their young safe and warm; a place where they can be nurtured, fed and watered. A woman’s womb plays a similar role. Each month the womb lining develops a lush, nutrient-rich, blood-engorged tissue; the womb is ready to receive the embryo and build a healthy placenta to supply all the nutrients the embryo needs to grow strong and healthy. If the mother’s diet that month is poor, the womb lining will be poor, and a weak placenta is less likely to sustain an embryo. So the eggs and womb lining are both dependent upon a good diet.

      Successful implantation depends upon a complex two-way ‘conversation’ between the blastocyst and the endometrium, which enables the embryo to implant at a site that is receptive. The nutrition producing hormonal balance, sperm and ova maturation, and a receptive endometrium, all at the same time, needs to be sound to achieve a pregnancy.

      • CASE STUDY •

       Wendy M of London

       Tears of undiagnosed endometriosis had led to the removal of a large ovarian cyst. Conventional treatments for the endometriosis and infertility had been to no avail. A visit to the nutritionist meant a substantial change to my diet and some vitamin supplements were taken. Within a few months period pains and bloating were less severe, PMS had virtually gone and I became pregnant. Yippee!

      WHY IT TAKES 12 MONTHS