Hearing the word endometriosis can instantly bring up fears about fertility and pregnancy.
If you’ve recently been diagnosed (or maybe endometriosis is something you’ve been living with for years), it’s completely natural to wonder what it means for your chances of having children.
The reality is that endometriosis can make it harder to get pregnant, but many people with endometriosis still go on to have healthy pregnancies — with the right information, planning, and sometimes fertility treatment.
This article will explain how endometriosis affects fertility and the chances of pregnancy, how to get pregnant with endometriosis (naturally and with treatment), and what to expect with endometriosis and pregnancy.
Can You Get Pregnant With Endometriosis?
Yes, you can get pregnant with endometriosis. Your chances depend on factors like how severe the disease is, whether your tubes and ovaries are affected, your age, and your partner’s fertility.
This means everyone’s experience of endometriosis is completely different. Some people with mild endometriosis conceive without any difficulty, while others with more advanced disease face significant challenges.
The following table outlines the key factors that can influence your chances of getting pregnant with endometriosis, and what they might mean for your fertility journey.
|
Factors that Influence Pregnancy Chances With Endometriosis |
||
|
Factor |
How It Can Affect Pregnancy |
What This May Mean for You |
|
How advanced the endometriosis is |
Mild endometriosis may have little effect on fertility, while more advanced disease can interfere with reproduction through inflammation, scarring, and anatomical changes. |
Pregnancy may happen naturally in milder cases, while more advanced stages may require closer monitoring or fertility treatment. |
|
Whether tubes and ovaries are affected |
Scar tissue and adhesions can block the uterine tubes or disrupt ovarian function, making it harder for eggs and sperm to meet. |
Imaging, surgery, or assisted reproductive techniques may be recommended depending on the extent of involvement. |
|
Age and ovarian reserve |
Fertility naturally declines with age, and some people with endometriosis may also have a lower ovarian reserve, particularly after ovarian surgery. |
Earlier fertility evaluation or planning may be helpful if pregnancy is a goal. |
|
Partner’s sperm health |
Sperm quality (including count, movement, and shape) plays a critical role in conception and can affect pregnancy chances regardless of endometriosis. |
A semen analysis can help identify whether male-factor fertility issues are also playing a role. |
How Endometriosis Affects Fertility
To understand how endometriosis affects fertility, it can be helpful to first understand what exactly endometriosis is and what it does.
Here’s a quick overview:
-
Endometriosis is a condition that causes tissue similar to the lining of the uterus to grow outside the uterus, creating a chronic inflammatory reaction.
-
This tissue can grow on the ovaries, fallopian tubes, the outer surface of the uterus, and other pelvic organs.
-
This tissue responds to hormonal changes throughout the menstrual cycle, just like the uterine lining does, but it has nowhere to go. This leads to inflammation, scarring, and the formation of adhesions.
The presence of this inflammation and scar tissue can make it harder for the egg and sperm to meet or for an embryo to implant, which is the underlying cause of fertility problems with endometriosis.
Here’s a more in-depth look at the main biological ways endometriosis can interfere with fertility, and how these changes may impact the chances of pregnancy.
|
How Endometriosis Interferes With Fertility |
||
|
What’s Happening in the Body |
Impact on Fertility |
|
|
Distorted anatomy |
Scar tissue (adhesions) can block or distort the fallopian tubes, interfere with egg pickup after ovulation, or prevent sperm and egg from meeting. |
Conception may be difficult or impossible without medical support if sperm and egg cannot meet naturally. |
|
Changes in ovarian function |
Endometriomas can damage healthy ovarian tissue, reducing ovarian reserve and affecting egg quality. |
Fewer available eggs or lower egg quality can reduce the chances of successful fertilization and pregnancy. |
|
Inflammatory pelvic environment |
Chronic inflammation creates conditions that can harm sperm, eggs, and embryos and interfere with implantation. |
Even when ovulation occurs, inflammation can lower the likelihood of fertilization or successful implantation. |
It's important to remember that these are the different ways endometriosis can potentially interfere with getting pregnant, not a guarantee that it will. The relationship between endometriosis and fertility is not always straightforward, and many people with the condition do go on to conceive.
Does Endometriosis Always Cause Infertility?
No, endometriosis does not always cause infertility.
Many people with mild endometriosis get pregnant without difficulty, and they may not even know they have the condition until it’s discovered during a test or procedure for an unrelated reason.
Fertility challenges are more likely with moderate to severe endometriosis, particularly when the fallopian tubes or ovaries are affected. Even then, an endometriosis diagnosis doesn’t mean pregnancy isn’t possible. Many people who experience fertility issues related to endometriosis are still able to conceive with the right treatment and support.
Chances of Pregnancy With Endometriosis
Your chances of pregnancy with endometriosis are highly individual and depend on your age, how extensive the disease is, whether your tubes are open, and whether there are any additional fertility issues.
Because of this, pregnancy rates with endometriosis can vary widely. Some people find it harder to conceive, while others get pregnant with little difficulty.
In general, research shows that a healthy couple has about a 15-20% chance of conceiving in any given menstrual cycle. For people with endometriosis, that monthly chance may be lower, sometimes closer to 2-10%. While that reduction can feel discouraging, it’s important to remember that it’s not zero. Pregnancy is still possible.
How to Get Pregnant With Endometriosis
Getting pregnant with endometriosis usually means combining healthy habits, cycle awareness, and, when needed, targeted fertility treatment.
Below, we’ll walk through the different paths to conception, starting with ways to support pregnancy naturally, and then looking at when medical treatments or surgery may help improve your chances.
How to Get Pregnant With Endometriosis Naturally
Trying to get pregnant with endometriosis naturally often means focusing on the things you can support and control, like managing pain, taking care of your overall health, getting to know your cycle, and timing sex around your most fertile days. These steps can help create the best possible conditions for conception.
Here’s a closer look at practical, natural ways to support fertility when you’re trying to conceive with endometriosis.
|
Ways to Support Natural Conception With Endometriosis |
|
|
Approach |
Why It Matters |
|
Manage pain |
Pain during intercourse can be a major barrier to conception, so working with your doctor on a pain management plan can help make regular sex more comfortable and achievable. |
|
Support overall health |
A balanced, anti-inflammatory diet, regular moderate exercise, good sleep, and stress management can help reduce inflammation and support hormonal balance. |
|
Consider fertility-supporting products |
Some people find supportive products, such as fertility teas, helpful as part of a broader wellness routine. |
|
Avoid smoking and limit alcohol |
Smoking and alcohol can negatively affect hormone balance, egg quality, and overall fertility. |
|
Track your cycles |
If your periods are regular, tracking your cycle is crucial. Advanced hormone tracking tools (like Mira) can help you pinpoint your most fertile days, while the Basal Body Thermometer (BBT) can help confirm ovulation has occurred. |
|
Time intercourse |
Having sex regularly, especially during your fertile window, maximizes the chances of sperm and egg meeting. |
When to Consider Endometriosis Infertility Treatment or Surgery
If endometriosis and months of trying are still standing between you and pregnancy, your doctor may suggest fertility treatments or surgery to improve your chances of conceiving. Moving beyond natural attempts isn’t a failure; it’s often a practical next step based on how endometriosis is affecting your body.
People often move beyond natural attempts when there is:
-
Ongoing difficulty conceiving despite trying for the recommended time period.
-
Known moderate to severe endometriosis, especially if diagnosed through laparoscopy.
-
Known tubal problems or significant adhesions that would prevent natural conception.
-
Significant pain that interferes with quality of life and the ability to have regular intercourse.
-
Previous surgery that did not result in pregnancy.
Here’s an overview of the main fertility treatment options commonly used for endometriosis-related infertility, and how they may help.
|
Endometriosis Fertility Treatment Options |
||
|
Treatment Option |
What It Involves |
When It May Be Recommended |
|
Fertility medications (sometimes with IUI) |
Oral medications like clomiphene citrate or letrozole, or injectable gonadotropins, are used to stimulate ovulation and may be combined with intrauterine insemination (IUI), where sperm is placed directly into the uterus around ovulation. |
Often used for mild endometriosis, irregular ovulation, or unexplained infertility, especially when tubes are open. |
|
Laparoscopic surgery |
Minimally invasive surgery to remove endometriosis lesions, cysts, and adhesions, which can improve pelvic anatomy and reduce inflammation. |
Most effective for minimal to mild endometriosis, and sometimes helpful in more severe cases when performed by an experienced surgeon. |
|
In-vitro fertilization (IVF) |
Eggs are retrieved directly from the ovaries, fertilized in a lab, and the resulting embryos are transferred to the uterus, bypassing tubal and pelvic factors. |
Often recommended after unsuccessful surgery or multiple failed IUI cycles, or when tubal damage or severe endometriosis is present. |
Pregnancy With Endometriosis: What to Expect
Once you’re pregnant with endometriosis, most pregnancies go well, but your healthcare team may monitor you more closely for pain or pregnancy-related complications.
While many people have healthy, uneventful pregnancies, research shows that endometriosis is associated with a slightly higher risk of certain issues. It’s important to be aware of these without being alarmed, as close prenatal care can help manage them.
Your prenatal care will likely include taking prenatal vitamins as guided by your clinician, and you may have more frequent check-ups. This extra care isn’t a sign that something is wrong; it’s simply a proactive way to support both you and your pregnancy to ensure the healthiest possible outcome.
How Endometriosis Can Affect Pregnancy and Symptoms
Endometriosis can change during pregnancy. Some people notice that their symptoms improve, while others continue to have pain or discomfort.
This is because during pregnancy, the absence of ovulation and higher progesterone levels can suppress endometriosis lesions, which often leads to reduced pain. At the same time, the growing uterus and added pressure on existing scar tissue or adhesions can cause discomfort for some.
If you notice any new or unusual symptoms, it’s always worth bringing them up with your doctor.
When to See a Doctor About Endometriosis and Fertility
If you have endometriosis and have been trying to get pregnant for:
-
At least 12 months (if under age 35) or
-
At least six months (if over age 35)
It's time to see a doctor or a certified fertility specialist. Because endometriosis is a known risk factor for infertility, the timeline for seeking help is often shorter than for the general population, so it’s best to check in as soon as possible to get the very best guidance and support.
What a Fertility Workup for Endometriosis Usually Involves
If your doctor suspects endometriosis, they may recommend a fertility workup to better understand what’s going on inside your body and why conception may be taking longer than expected.
This workup typically includes:
-
Basic pelvic exam and medical history evaluation.
-
Transvaginal ultrasound to look for endometriomas or other structural issues.
-
Ovarian reserve and hormone testing to check your egg supply and other key hormones.
-
Semen analysis of your partner’s sperm to rule out any male-factor issues.
The goal is to understand exactly how endometriosis (and any other contributing factors) may be affecting your fertility, so your care team can choose the most effective, personalized treatment plan.
Step-by-Step Plan for Getting Pregnant With Endometriosis
Trying to conceive with endometriosis can feel overwhelming, especially when there’s no single, guaranteed path forward. Breaking the process into manageable steps can help you feel more in control and make it easier to decide what to do next based on how your body responds.
Here’s a simple, step-by-step plan to help guide the process:
-
Confirm your diagnosis: Work with a doctor to understand the stage and location of your endometriosis.
-
Support your overall health: Focus on an anti-inflammatory lifestyle to manage your symptoms and support fertility.
-
Track your cycles: Use tools like hormone monitors, cycle-tracking apps, and BBT thermometers to identify your fertile window and plan sex accordingly.
-
Try timed intercourse: Attempt to conceive naturally for a defined period based on your age and diagnosis.
-
See a fertility specialist: If you don’t conceive within that window, consult a reproductive endocrinologist.
-
Discuss treatment options: Work with your specialist to decide if surgery, IUI, or IVF is the right next step for you.
Frequently Asked Questions
Does endometriosis affect fertility?
Endometriosis can affect fertility, but it doesn’t affect everyone in the same way. For some people, it causes inflammation or scar tissue that makes it harder for an egg and sperm to meet or for an embryo to implant. For others (especially those with milder forms of endometriosis), it may have little to no impact at all. Many people with endometriosis do go on to get pregnant, sometimes naturally and sometimes with a bit of extra medical support.
Can you get pregnant with endometriosis if your periods are regular?
Yes, it is possible. Regular periods are a good sign of regular ovulation, but endometriosis can still affect fertility through inflammation or by blocking the fallopian tubes.
Does pregnancy cure endometriosis?
No, pregnancy does not cure endometriosis. While pregnancy can temporarily suppress symptoms, the condition usually remains after delivery.
Can endometriosis come back after pregnancy?
Yes, endometriosis symptoms and lesions can return after pregnancy once your menstrual cycle resumes.
Do you always need IVF if you have endometriosis?
No, not at all. Many people with endometriosis conceive naturally or with less invasive treatments like intrauterine insemination (IUI).
Can endometriosis get worse after pregnancy or delivery?
For most people, endometriosis symptoms are suppressed during pregnancy. However, the return of your menstrual cycle after delivery can bring a return of symptoms, which may feel different than before.
