Endometriosis and Fertility: What You Need to Know

Endometriosis And Fertility –

How Does Endometriosis Affect Fertility?

Endometriosis can make getting pregnant harder in different ways. Here’s how:

1. Inflammation Makes the Uterus Less Welcoming for Pregnancy

• Endometriosis causes inflammation, which is the body’s way of responding to irritation or injury.

• Inflammation can make the lining of the uterus less prepared for an embryo to attach and grow, lowering the chances of pregnancy​.

2. Hormonal Imbalances Can Disrupt Ovulation

• Women with endometriosis often have high levels of estrogen, a hormone that helps the lining of the uterus grow. Too much estrogen can make the condition worse.

• Some women also develop resistance to progesterone, another hormone needed for pregnancy. This means their uterus doesn’t respond properly to signals that help a fertilized egg implant​.

3. Scarring Can Block the Fallopian Tubes or Affect the Ovaries

• Endometriosis can cause scar tissue and cysts to form on the reproductive organs.

• If the fallopian tubes (which carry the egg from the ovary to the uterus) are blocked, the egg and sperm may never meet.

• If ovarian cysts form, they can damage healthy egg-producing tissue, lowering the number of eggs available for fertilization​.

4. Egg Quality Can Be Affected

• Endometriosis can increase oxidative stress, which damages cells—including eggs.

• This means some eggs may not develop properly, making fertilization and early pregnancy more difficult​.

Endometriosis And Fertility –

Can You Get Pregnant Naturally with Endometriosis?

Yes! Many women with endometriosis conceive without medical help, but the chances depend on:

· How severe the endometriosis is – Mild cases are less likely to affect fertility.

· Your age – Fertility naturally decreases after age 35.

· Whether your fallopian tubes are open – If they are blocked, the egg and sperm can’t meet.

· How long you’ve been trying – If you’ve been trying for over a year (or six months if you’re over 35), it’s best to see a specialist.

Women with mild endometriosis have a pregnancy rate of about 40-60% within two years of trying. However, those with more severe cases may need fertility treatments​.

Endometriosis And Fertility

Treatment Options for Endometriosis-Related Infertility

If you’re struggling to get pregnant, several options can help:

1. Medications to Reduce Inflammation and Balance Hormones

• Birth control pills, progestins, or hormone treatments can help control endometriosis symptoms.

• However, these treatments don’t improve fertility—they’re used more for symptom relief.

2. Surgery to Remove Endometriosis Lesions and Scar Tissue

• Laparoscopic surgery can remove cysts, scar tissue, and other blockages that may be interfering with pregnancy.

• Many women see an increase in fertility after surgery, especially if their fallopian tubes are not affected​.

3. Fertility Treatments (IUI and IVF)

If natural conception isn’t happening, doctors may recommend:

• Intrauterine Insemination (IUI): A procedure where sperm is placed directly into the uterus to improve the chances of fertilization.

• In Vitro Fertilization (IVF): A process where eggs are taken from the ovaries, fertilized with sperm in a lab, and then placed back into the uterus​.

IVF can be especially helpful for women with moderate to severe endometriosis, as it bypasses some of the barriers caused by scarring and inflammation.

Ways to Improve Fertility with Endometriosis

Even if you’re not undergoing treatment, there are steps you can take to support your fertility naturally, thought they are not a treatment:

Eat an Anti-Inflammatory Diet

• Focus on leafy greens, omega-3-rich foods (salmon, walnuts, flaxseeds), and whole grains.

• Avoid processed foods, sugar, and excessive dairy, which can trigger inflammation​.

Manage Stress

• High stress can interfere with hormones that control ovulation.

• Activities like yoga, meditation, and acupuncture may improve relaxation and hormonal balance​.

Stay Active but Avoid Overexercising

• Moderate exercise (walking, swimming, yoga) helps reduce inflammation and supports fertility.

• However, excessive exercise can disrupt ovulation, so it’s important to find balance.

Consider Supplements

• Vitamin D, vitamin C, and antioxidants can help reduce inflammation and support reproductive health​.

• Talk to your doctor before starting any new supplements.

Endometriosis And Fertility –

When to See a Doctor

If you have endometriosis and are trying to conceive, see a doctor if:

· You’ve been trying for over a year (or six months if over 35).

· You have severe pain during periods or sex.

· You’ve had previous surgeries for endometriosis.

· You suspect blocked fallopian tubes or ovarian cysts.

Early evaluation and treatment can improve your chances of a successful pregnancy.

Endometriosis And Fertility –

Conclusion

Endometriosis doesn’t mean infertility—but it can make conception more challenging. The good news is that many women with endometriosis go on to have healthy pregnancies, whether naturally or with the help of fertility treatments.

Understanding how endometriosis affects fertility, available treatment options, and lifestyle changes can help you take control of your reproductive health and increase your chances of conceiving.

References

1. Latif, S., et al. Endometriosis and In Vitro Fertilization. Medicina 2024​.

2. Tsuei, A., et al. Comprehensive Management of Bowel Endometriosis: Surgical Techniques, Outcomes, and Best Practices. J. Clin. Med. 2025​.

3. Dymanowska-Dyjak, I., et al. Oxidative Imbalance in Endometriosis-Related Infertility—The Therapeutic Role of Antioxidants. Int. J. Mol. Sci. 2024​.

4. Bayu, P., et al. Vitamin C and E Antioxidant Supplementation May Significantly Reduce Pain Symptoms in Endometriosis. PLoS ONE 2024​.

5. Chen, C., et al. Acupuncture for Clinical Improvement of Endometriosis-Related Pain: A Systematic Review and Meta-Analysis. Arch Gynecol Obstet 2024​.