Endometriosis and Fertility Options

Endometriosis is a prevalent condition that affects 6–10% of women and is associated with an increased risk of fertility problems. Approximately 30% to 50% of women with endometriosis may experience difficulties getting pregnant. While it is possible to have a baby if you have endometriosis, seeking medical assistance might be necessary to enhance your chances of conception and successful delivery.

What is endometriosis?

During pregnancy, a baby develops within the uterus, also known as the womb. Tissue (endometrium) lines the inside of the uterus. A condition known as endometriosis causes tissue that resembles the lining of the uterus to grow in other parts of the body. These tissue patches are referred to as “lesions,” “implants,” or “nodules.” As a result, symptoms such as pain, prolonged and intense menstrual periods, and potential fertility issues may arise.

There exists a classification system for assessing endometriosis, consisting of four stages:

Stage I (minimal disease): Characterized by a few small implants (specs) of endometriosis, and no observable scar tissue.

Stage II (mild disease): involves more implants for endometriosis, but the affected area in the abdomen is less than 2 inches, and scar tissue is absent.

Stage III (moderate disease): Presents a considerable amount of endometriosis in the abdomen, potentially deep-seated, forming pockets of endometriotic fluid (chocolate cysts or endometriomas) in the ovaries. Scar tissue may be present around the tubes or ovaries.

Stage IV (severe): Marked by a significant number of endometriotic implants, probable big endometriotic cysts in the ovaries, and possible scarring around the fallopian tubes and between the uterus and the rectum (lower portion of the intestines).

Endometriosis Causes

Endometriosis can happen when tissues from the lining of the uterus move around the body through the blood or lymphatic systems, a bit like how cancer cells spread.

Surgeries, like C-sections or hysterectomies, can lead to endometrial cells attaching to the abdomen.

If endometrial tissue doesn’t leave the body during a period, it might go into the fallopian tubes and abdomen. Sometimes, cells in the body change to become endometrial cells and grow outside their usual spot.

Genetic factors can also play a role, making endometriosis more likely in certain families.

How do I know if I have endometriosis?

Abdominal or pelvic discomfort is a common symptom of the illness in many women, particularly during menstruation or sexual activity. Some people might not exhibit any symptoms. Endometriosis, which affects 30% to 50% of women, can hamper infertility.

Unlike normal endometriotic tissue, it can occasionally develop cysts inside the ovary (endometriomas), which can be seen with ultrasonography. A laparoscopy is a surgical technique that is the sole conclusive means of diagnosis.

How does endometriosis impact pregnancy?

Endometriosis-related fertility problems can arise from several causes. Firstly, this illness may interfere with an egg’s normal path if it affects the ovaries or fallopian tubes. The fallopian tube usually transports the egg from the ovary to the uterus, where fertilization occurs, and the fertilized egg then implants into the uterine lining.

Moreover, endometriosis that damages the fallopian tube lining may provide a barrier to the egg’s easy passage towards the uterus. Additionally, endometriosis might negatively impact the sperm or the egg. Although the precise reasons for this association remain unclear, experts suggest that increased inflammation in the body contributes to it.

What are the available treatments for endometrial infertility?

A specialist considers several criteria while evaluating a patient’s reproductive difficulties, including age, general health, symptoms, and desire for motherhood. The physician then makes a number of therapy recommendations after assessing the case. Depending on the needs of the patient, these alternatives might include surgery, medicine, or a mix of both.

Simple pain medication may be adequate for minor symptoms. If there are any abnormal tissue growths, a medical professional can remove them via a laparoscope. Rare circumstances may require open surgery for more complex conditions. In addition to carefully weighing all of your options and taking into account when you should expect a child, the fertility specialist provides advice on how to manage symptoms as you go.

Fertility doctors usually prescribe in vitro fertilization (IVF) if the pregnancy does not develop within 6–12 months following surgery for moderate to severe endometriosis. This is especially recommended in cases with extensive scar tissue or obstructed fallopian tubes. In such cases, the doctor could advise moving straight to in vitro fertilization as it provides the highest possibilities of success in conceiving a child instead of pursuing alternative procedures.


Getting a diagnosis of endometriosis can take a long time and be frustrating. However, if you think you have it, keep a record of your symptoms for your doctor. Treatment can help many women feel better, yet the symptoms might come back even after surgery. It’s important to have regular check-ups with your doctor to ensure you are closely monitoring any signs of the symptoms returning.


9M Fertility

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