If you are trying to conceive—or planning for the future—and have been diagnosed with or suspect you have endometriosis, it is completely normal to have questions about your reproductive health. Many women worry about whether endometriosis and fertility can coexist, asking critical questions like: Can you get pregnant with endometriosis? and Does endometriosis cause infertility?
Endometriosis is commonly linked to infertility, with about 10 – 30% of people diagnosed with endometriosis having experienced infertility. However, an endometriosis diagnosis does not mean pregnancy is impossible as 7 out of 10 people with mild to moderate endometriosis are able to naturally conceive. Understanding how endometriosis affects fertility, recognizing signs of endometriosis, and knowing your endometriosis fertility treatment options can help you take proactive steps toward building your family.
What is Endometriosis?
Endometriosis is a chronic condition where tissue similar to the uterine lining grows outside the uterus, commonly on the ovaries, fallopian tubes, bladder, or bowel. During menstruation, this misplaced tissue thickens and bleeds like normal uterine tissue, but with no way to exit the body, the trapped fluid causes inflammation, severe pain, scar tissue, and painful tissue buildup.
Learn more about period cramps and endometriosis here.
How Does Endometriosis Affect Fertility?
A major concern for many is how endometriosis affect fertility. Endometriosis can impact women’s fertility through several biological mechanisms, even in women who have regular periods.
Structural Distortion and Blocked Fallopian Tubes
As endometrial lesions bleed each month, they create pelvic adhesions and scar tissue. This tissue can cause organs to stick together, distorting the pelvic anatomy. If scar tissue blocks the fallopian tubes or binds the ovaries, it prevents the egg and sperm from meeting, directly contributing to endometriosis infertility.
Hormones, Ovulation, and Egg Quality
Ovulation and hormones
Inflammatory cells in the pelvic fluid and ovarian cysts (endometriomas) can interfere with normal ovarian function, altering egg production and ovulation. As the body resists progesterone – important for pregnancy – this prevents the lining of the uterus from preparing for an embryo
Egg Quality
Severe cases of endometriosis can lower egg and embryo quality while reduced total egg supply (ovarian reserve). Extra free radicals in the uterus also triggers oxidative stress, which further harms embryo survival.
Endometriosis Fertility Treatment Options
If endometriosis causes difficulty conceiving, a combination of medical, surgical, and reproductive technologies can help:
- Laparotomy: Laparoscopic surgery removes implants and endometriomas, and restores pelvic anatomy.
- Fertility Preservation: Endometriosis egg freezing allows women to preserve healthy eggs before surgery or age-related decline. This is highly recommended before complex ovarian cyst surgery.
- Ovulation Induction & IUI: Fertility medications paired with intrauterine insemination help optimize the timing of egg and sperm, which can be effective for mild to moderate cases.
- In Vitro Fertilization (IVF): IVF bypasses the fallopian tubes entirely by fertilizing eggs in a lab setting. It offers the highest endometriosis and IVF success rates for moderate to severe cases.
Managing Your Reproductive Health
If you are navigating endometriosis and getting pregnant, remember that an endometriosis diagnosis is not a final verdict on your ability to have a child. Working closely with a specialist can help you explore treatment options and take proactive steps to help increase your chance of conceiving and carrying a healthy pregnancy
References
- Fibra. “Period Cramps or Endometriosis: How Can You Tell the Difference?” Read our article.
- Pregnancy Info. “Endometriosis and Fertility.” Read the SOGC article.
- Tommy’s. “How does endometriosis affect fertility?” Read the Tommy’s article.
- Elsevier. “Endometriosis and Infertility: A Review of the Pathogenesis and Treatment of Endometriosis-associated Infertility.” Obstetrics and Gynecology Clinics of North America. Read the article.
- MDPI. “Fertility Preservation in Women with Endometriosis.” Journal of Clinical Medicine. Read the article.