Does Endometriosis Affect Fertility?

If you have—or suspect you may have—endometriosis, you might have concerns about your ability to get pregnant. While some women with endometriosis may find it harder to conceive, many can get pregnant on their own. And those who are unable to get pregnant on their own can often conceive after receiving the right fertility treatment. Here’s what you need to know about endometriosis and getting pregnant.

What Is Endometriosis?

The tissue that lines the uterus is called the endometrium. The condition endometriosis happens when this lining grows in areas outside the uterus, such as the fallopian tubes, ovaries, or other areas of the pelvis. The areas where this tissue implants can cause inflammation and scarring, and symptoms can include mild to severe discomfort—or even pain—during ovulation and menstruation.

While some women may have a few “spots” where these growths occur, for others endometriosis can be extensive. Endometriosis is often diagnosed using four stages—minimal (Stage 1), through extensive (Stage 4). Women can experience pain from endometriosis at any stage of diagnosis, but the higher stages of endometriosis have a more significant negative effect on fertility.  A woman’s fertility may be affected when endometriosis leads to pelvic adhesions or scarred fallopian tubes, making it more difficult to become pregnant.

The main cause of endometriosis is unknown and still being researched; however, possible causes may include problems with menstrual flow, genetic factors, hormones, or previous surgeries.

Does Endometriosis Affect My Chances of Getting Pregnant?

It can, but an endometriosis diagnosis does not mean you’re infertile. The inflammation caused by endometriosis can make certain steps of conception a bit more challenging. For instance, swelling and scar tissue in the fallopian tubes can make it more difficult for the sperm and egg to meet, or get in the way of an embryo successfully implanting in your uterus. 

While there are certainly a portion of women with endometriosis who experience infertility, many are able to conceive on their own. Others may need the help of a fertility specialist and treatments to get pregnant and carry a healthy baby to term. Your ability to get pregnant is simply unique to you (and your partner). 

I Have Endometriosis—What Should I Do to Prepare for Getting Pregnant?

The first and most important step for anyone trying to conceive is to talk to your provider about your plans for pregnancy. Depending on a few factors (such as age and your specific diagnosis), your provider will be able to help you create a game-plan for trying to conceive.

There’s usually no harm in women diagnosed with endometriosis trying to get pregnant on their own. However, if you have endometriosis and aren’t pregnant after six months or so of trying, your provider may refer you to a fertility specialist to understand more about your specific condition and your chances of conceiving naturally.

What If I Don’t Get Pregnant Naturally?

After a review of your health history and an examination of the extent of your endometriosis —typically done through a series of tests—your provider or fertility specialist might suggest a few different avenues, which could include:

• Surgery: It’s possible to remove lesions, endometriomas (cysts of endometriosis on the ovary) and scarring through laparoscopic surgery. This can help lessen the pain and discomfort caused by endometriosis, and may also improve your chances of getting pregnant. It’s important to note that multiple surgeries can cause scar tissue to form, which may have an adverse effect on conception. Your provider can assess your individual case and help you decide on the pros and cons of surgery.
• IUI (intrauterine insemination): Through this process, your provider will place sperm from your partner directly into the uterus. This allows for a higher number of sperm to reach the Fallopian tubes (the site of fertilization) and is often combined with medications to help boost ovulation. 
• IVF (in vitro fertilization): If you still aren’t getting pregnant, IVF is a great option for those with endometriosis. Through IVF, your eggs are fertilized in a lab to create embryos, which are then transferred directly into your uterus. While IVF is not an easy (or cheap) process, those with and without endometriosis have similar success rates.

If you’re trying to get pregnant and have endometriosis, our specialists at Penn Fertility Care - Lancaster General Health can work with you to create a plan to achieve your pregnancy goals. To learn more about our fertility services, visit LGHealth.org/Fertility, or call 717-544-0107. We’re wishing you luck on your fertility journey!