Short answer: Endometriosis can make it harder to get pregnant, but its impact varies and many women become pregnant without fertility treatment. Pain, previous surgeries, fallopian tube function and age may be relevant in the assessment. An individual plan needs to balance both symptom relief and the desire for pregnancy.
What is endometriosis?
In endometriosis, uterine lining-like tissue is located outside the uterus, for example on the ovaries, fallopian tubes or the pelvic peritoneum. The tissue reacts to hormonal fluctuations during the menstrual cycle, which can cause inflammation, pain and, over time, adhesions.
How does endometriosis affect fertility?
Endometriosis can affect the chances of becoming pregnant in several ways: adhesions can alter the anatomy and make it harder for the egg to travel through the fallopian tube; an inflammatory environment with increased oxidative stress can affect egg and embryo quality; and hormonal changes can disrupt ovulation and implantation. The extent to which fertility is affected varies greatly from person to person.
Can you still get pregnant?
Yes. For some, IVF may be necessary, while others become pregnant without treatment. Surgery is not automatically the best route to pregnancy. ESHRE advises against routine surgery for endometriomas before assisted reproduction solely to improve the chances of a live birth; the procedure may affect the ovarian reserve.
When should you seek help?
If you have severe menstrual pain, pain during intercourse or difficulty becoming pregnant, it is worth seeking medical care. If you want to become pregnant and have known endometriosis, it may be wise not to wait too long for an assessment.
This article provides general information and does not constitute medical advice. Contact healthcare professionals for assessment and treatment.
Sources
- Endometriosis and infertility: pathogenesis and treatment (review article). PMC3538128.
- ESHRE: endometriosis guidelines, 2022