Estimated reading time: 7 minutes
- Endometriosis affects 10% of reproductive-age women and can impact fertility - but having the condition doesn't mean you can't get pregnant
- Key signs include chronic pelvic pain, pain during sex or ovulation, and heavy periods
- Treatment options include laparoscopic surgery, IVF, or IUI, depending on your specific situation
Endometriosis and Infertility Impact
Endometriosis affects roughly 10% (190 million) of reproductive-age women and girls globally. While it is under-studied and under-diagnosed, much is being done to raise its public understanding and offer solutions to this chronic condition.
It is caused by tissue similar to the uterine lining growing outside the uterus, leading to chronic inflammation and pain throughout the body. For many, one of its most devastating impacts is on fertility. Infertile women are 6 to 8 times more likely to have endometriosis than fertile women.
However, it is not a given. This recent study reports that having endometriosis doesn't mean you won't be able to conceive - about 30–50% of endo cases are impacted by infertility. Many women with the condition do successfully become pregnant, either naturally or with fertility treatments.
How Does Endo Cause Fertility Issues
Endometriosis can affect fertility in several ways, from creating physical barriers in your reproductive system to changing how your body supports conception and pregnancy.
Endometriosis Adhesions
The condition causes a continuous cycle of inflammation and healing. When endometrial-like tissue grows outside the uterus, it responds to hormonal changes just like the tissue inside the uterus - it swells, breaks down, and bleeds with each menstrual cycle. However, unlike normal menstrual blood that exits the body, this tissue has nowhere to go.
This trapped blood and tissue triggers an inflammatory response, causing the body to produce scar tissue (adhesions) as part of its natural healing process. This scaring may block or distort the fallopian tubes, preventing eggs from meeting sperm. These adhesions can also affect the ovaries, potentially interfering with regular ovulation.
Endometriosis Inflamed Pelvis + Egg Quality
Additionally, endometriosis can create an inflammatory environment in the pelvis that may impair egg quality, reduce embryo implantation, and alter the immune system's normal response during conception.
Even in mild cases where there's no visible blockage, the inflammation caused by endometriosis can alter hormone levels, disrupt the normal immune response needed for conception, and change the chemical composition of peritoneal fluid (the liquid in the pelvic cavity), making it harder to achieve and maintain pregnancy.
Signs Endo is Causing Infertility
Understanding the connection between endometriosis and fertility starts with recognizing common and key symptoms:
- Chronic pelvic pain
- 70% of PatientsLikeMe members diagnosed with endometriosis report severe pelvic pain
- Heavy bleeding during periods or between periods
- Severe pain during intercourse or ovulation
- 62% of PatientsLikeMe members diagnosed with endometriosis report severe pain during intercourse or ovulation
- Bloating or nausea
- Fatigue
- Depression or anxiety
These can all signal that endometriosis might be affecting your reproductive health. By identifying these signs early and working with healthcare providers, women with endometriosis can better understand their fertility options and develop appropriate treatment plans.
Ways to Get Pregnant with Endometriosis
When endometriosis affects your fertility, healthcare providers often offer three main treatment options that can help you become pregnant: laparoscopic surgery to remove endometriosis tissue, IVF to create embryos in a lab, and IUI to place sperm directly in the uterus. Your doctor will recommend the best option based on your specific situation and the severity of your endometriosis.
Laparoscopic Surgery for Endometriosis
Laparoscopic surgery for endometriosis, often called excision surgery, involves removing endometrial lesions and scar tissue through small incisions in the abdomen. During this minimally invasive procedure, your surgeon carefully removes endometriosis tissue while preserving healthy reproductive organs.
Research shows this surgery can significantly improve fertility, especially in the first year after surgery. For many women, removing endometriosis deposits reduces inflammation. It restores normal pelvic anatomy by freeing blocked fallopian tubes, separating organ adhesions, and reducing inflammatory factors that can interfere with fertilization and implantation.
I opted for laparoscopic surgery since my OB/GYN at the time didn't recommend hormone treatments. The surgery really made a difference - it helped with both my pain a lot and made me feel like I could actually attempt getting pregnant. My doctor removed the endometriosis tissue, and the effects lasted longer than I expected"
PatientsLikeMe Member since 2005
In Vitro Fertilization (IVF) treatment
IVF is one of the most commonly discussed and extensively researched fertility treatments available. While the complete IVF journey involves many detailed steps, decisions, and considerations, we'll focus on how it specifically helps women with endometriosis. IVF bypasses many fertility barriers caused by endometriosis by directly uniting egg and sperm in a laboratory.
The process begins with hormone medications to stimulate egg production, followed by egg retrieval through a minor procedure. These eggs are fertilized with sperm in the lab to create embryos, and the healthiest embryo is transferred directly into the uterus. IVF can be particularly effective for endometriosis patients because it overcomes issues like blocked fallopian tubes and the challenges of adhering to a scarred uterine lining/wall.
IVF is a significant commitment - emotionally, physically, and financially. We recommend consulting with a fertility specialist to understand the process, success rates fully, and whether this treatment path is right for you.
My story is not unique as there are already many women who successfully gave birth when they have endo. I become pregnant after the second IVF cycle, so don't always expect success right away. I went into hospital a few times for scrapes etc. before I started my treatment too which I think helped the second time aroind round."
PatientsLikeMe Member since 2020
Intrauterine Insemination (IUI)
IUI involves placing specially prepared sperm directly into the uterus during ovulation. This treatment may be recommended for women with minimal to mild endometriosis who still have open fallopian tubes. During an IUI cycle, fertility medications may be used to stimulate ovulation, and timing is carefully monitored.
When ovulation occurs, the sperm is inserted through a thin catheter, bypassing any cervical obstacles. While generally less successful than the direct IVF route for endometriosis patients, IUI can be a good first-line treatment for some couples, especially when combined with fertility medications.
Starting Your Fertility Journey
Deciding how to move forward with fertility treatment is a highly personal decision. Work closely with your healthcare team to create a treatment plan that fits your specific situation, taking into account the severity of your endometriosis, your age, overall health, and personal preferences.
Living with Endometriosis and Planning for Pregnancy With PatientsLikeMe
If you're wondering about endometriosis and fertility, you're not alone. With PatientsLikeMe you can compare different fertility treatments, see real-world success rates, and learn from others' experiences with both endometriosis and fertility treatments. Our tracking tools help you monitor your symptoms, treatment side effects, and progress over time – valuable information to share with your healthcare team.
Plus, our community members regularly share tips about insurance coverage, affordable medication options, and ways to navigate the healthcare system more effectively. You'll find resources to save you time and money and, most importantly, connect with others who truly understand this journey. Together with your healthcare providers and our supportive community, you can develop and follow a plan that works best for you.
