How does endometriosis affect fertility? It is a frequent question we get asked, and understandably, as this is a prevalent condition that affects roughly 1 in 10 women of reproductive age and negatively impacts fertility in several ways.[1]

Fortunately, endometriosis can be manageable with the right tools and guidance. For this reason, we will tackle everything you need to know about endometriosis: how it impacts fertility, its symptoms and stages, how to address it, and more  – all to optimize your health and improve your fertility, resulting in better chances of bringing home a healthy baby.

Endometriosis and Fertility

Scientifically, it has been established that endometriosis and infertility are intertwined. Approximately 35-50% of women with pelvic pain and infertility have been diagnosed with endometriosis.[2] A clear understanding of disease status is relevant because this condition can significantly impact one’s chances of conceiving and having a healthy pregnancy.

Depending on several factors, endometriosis can affect a woman’s ability to conceive. It includes whether she develops an endometrioma (concentrated in the ovary) or if she develops it in her pelvis or fallopian tubes. Regardless of placement, this condition can negatively impact egg quality due to increased inflammation in the pelvic region and can also impact implantation.[3-6]

Symptoms and Stages of Endometriosis

Symptoms can range from crippling and debilitating to being described as ‘silent’ with no symptoms. It is tricky to know who may or may not have endometriosis as the signs and symptoms vary dramatically.[7]

Some women with endometriosis have no symptoms. Those with symptoms may feel endometriosis pain during intercourse, bowel movements, or urination, as well as around the pelvic area, which intensifies during menstruation. Other women have very mild endometriosis, yet because of where the adhesions are forming, they have a lot of symptoms. 

In addition, there are four gradings of endometriosis. Grade IV is the most severe — anything from grade II to grade IV will moderately to severely impact the ability to conceive and keep a healthy pregnancy to term.[7,8]

How to Address Endometriosis

Treatments vary from medications, therapies, and surgeries. Like fibroids, you cannot necessarily reverse it with natural treatment alone. However, since the diagnostic process is quite invasive, it is essential to understand all the critical signs and clues before plunging into a surgical procedure that may also impact fertility.

Regarding addressing endometriosis, we must look at the following first:

  1. What possible causes and cascade of consequences must we become aware of?
  2. Are other ‘areas of concern’ exacerbating the condition and hindering the desired outcome of a healthy pregnancy and baby?
  3. What are the ‘areas of influence’ you can impact on supporting your body in regaining and sustaining optimum reproductive and general health?

It is important to note that once we have a handle on all the different ‘minor factors’ or obstacles that plays a role in endometriosis, we may recommend surgery depending on the severity of the condition.[8,9]

Chances of Conceiving with Endometriosis

Numerous studies verify the association between endometriosis and infertility, but a definite cause-effect relationship is still controversial.[10] In the same way that the condition’s causes are still relatively unknown (though studies have looked into possible ones), it is still unclear whether endometriosis causes infertility.

However, with the anatomical and hormonal factors brought by the condition, it can be concluded that there are decreased chances of getting pregnant with endometriosis. Although, some women diagnosed with the condition can conceive anyway.

Final Thoughts

After over two decades in our practice, we have proven that overcoming reproductive challenges such as endometriosis entails adequate diagnosis and effective holistic treatment. So if you would like us to assess your specific situation and point you in the best direction moving forward, schedule a complimentary consultation with us here.

You can also check out our 12-part Debunking Endometriosis series on Fertility Edutok for more tips on managing endometriosis and optimizing your fertility for the best results:

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[1] Zondervan KT, Becker CM, Missmer SA. Endometriosis. N Engl J Med. 2020 Mar 26;382(13):1244-1256. doi: 10.1056/NEJMra1810764.
[2] Bulletti C, Coccia ME, Battistoni S, Borini A. Endometriosis and infertility. J Assist Reprod Genet. 2010;27(8):441-447. doi:10.1007/s10815-010-9436-1
[3] Holoch, K.J., et al. Endometriosis and Infertility. Clinical Obstetrics & Gynecology, 2010. 53(2). PMID: 20436320.
[4] Llarena, N.C., et al. Fertility Preservation in Women With Endometriosis. Clinical Medicine Insights: Reproductive Health, 2019. PMID: 31516316.
[5] Hodgson, R.M., et al. Interventions for Endometriosis-Related Infertility: A Systematic Review and Network Meta-Analysis. Fertility & Sterility, 2020. 113(2). PMID: 32106991.
[6] Harb, H.M., et al. The Effect of Endometriosis on In Vitro Fertilisation Outcome: A Systematic Review and Meta-Analysis. BJOG, 2013. 120(11). PMID: 23834505.
[7] Parasar, P., et al. Endometriosis: Epidemiology, Diagnosis and Clinical Management. Current Obstetrics and Gynecology Reports, 2017. 6(1). PMID: 29276652.
[8] Fadhlaoui, A., et al. Endometriosis and Infertility: How and When to Treat? Frontiers in Surgery, 2014. PMID: 25593948.
[9] Zanelotti, A., et al. Surgery and Endometriosis. Clinical Obstetrics & Gynecology, 2017. 60(3). PMID: 28742580.
[10] Macer, M. & Taylor, H. Endometriosis and Infertility. Obstetrics and Gynecology Clinics of North America, 2012. 39(4), 535-549. doi:10.1016/j.ogc.2012.10.002