Adenomyosis can affect pregnancy, and so can coeliac disease, so is it more difficult for patients with both adenomyosis and coeliac disease? Is there no hope for pregnancy? In fact, pregnancy is the result of a combination of factors, and it is related to many aspects. It is true that having adenomyosis and coeliac disease at the same time will make it more difficult to get pregnant. However, it is not that there is no hope for pregnancy. Adenomyosis is a condition in which the endometrium (including the glands and mesenchyme) invades the myometrium and grows. The reason why it is not good to get pregnant is that adenomyosis lesions cause the uterine environment to become very poor, which makes the environment for the fertilized egg to be laid very poorly and not develop properly. In addition, adenomyosis lesions are located close to the fallopian tubes, causing them to become blocked and inaccessible, so that sperm and eggs cannot meet, and naturally, pregnancy is not possible. Some patients with adenomyosis do not have a poor uterine environment, but some aseptic inflammation caused by adenomyosis, or some inflammation that the patient has had, causes adhesions and obstruction of the fallopian tubes, which leads to infertility. In the case of coeliac disease, the endometrium is ectopic to the ovaries, and every time the menstrual period, there is local bleeding, causing the ovaries to enlarge and form cysts containing old blood, which is brown in color and sticky like paste, resembling chocolate, so it is also called “chocolate cyst”. The main reason why coeliacs affect pregnancy is that the growth of coeliacs leads to abnormal ovarian function, which prevents normal ovulation or adhesions in the fallopian tubes, resulting in the inability to transport eggs normally, thus affecting normal conception. In addition, untreated coeliacs may rupture and cause pelvic adhesions and pelvic inflammatory disease. This can also affect conception. What should women with adenomyosis combined with coeliac disease who want to have children do to have a better chance of getting pregnant? If your adenomyosis is not serious or your uterus is below 70mm and your coeliacs are less than 4cm, you can try to conceive first, if you want to get pregnant faster, it is recommended that you go to the hospital for follicle monitoring, the probability of winning each month for a completely normal couple is only 25%. It is not as easy as you think. The actual fact is that if you are successful, it will be 100% for you. I’m tired of follicle monitoring, and I have to run to the hospital a lot, but it’s all for the sake of the baby. You should observe whether the whole follicle development is normal and find the right day of ovulation to have intercourse so as to increase the chance of pregnancy. Once you get pregnant, remember to keep the baby. Otherwise, the poor environment of the uterine cavity caused by adenomyosis can lead to miscarriage of the fetus. 2.Treat the coeliacs before trying to conceive (for the following cases) The patients I ask you to treat the coeliacs before trying to conceive usually have adenomyosis that is not serious, but is still in the early stage of adenomyosis, and the coeliacs have grown to the size of 5cm. If the coelecyst is more than 5cm, pregnancy with the cyst is likely to cause rupture or torsion of the cyst, which can be life-threatening. Moreover, for such a large cyst, short-acting oral contraceptives are no longer sufficient, so surgery as soon as possible and pregnancy as soon as possible after surgery is the most effective way. For dealing with coeliac cysts, my advice is to take minimally invasive laparoscopic debridement for fast recovery. 3. Surgery for adenomyosis and coeliac at the same time and consider fertility after surgery If your uterus is already very large and the coeliac is more than 5cm, and you have been trying to conceive and have not been able to conceive. At this time, I recommend you to come to me for a uterine preservation surgery to solve the problems of adenomyosis and coeliac at the same time, and then two years after the surgery, you can come to evaluate the uterine fertile environment and consider the fertility problem. After reading the above answers, if you are still not sure what you should do, you can comment below my article or send a private message. Tell me about your specific situation and I will respond to your questions in my free time.