How Does Endometriosis Affect Fertility?
Endometriosis is a common condition that impacts 35-50% of women who struggle to conceive. Many women may not receive their diagnosis or notice any symptoms until beginning their path to parenthood.
While endometriosis can make it more challenging to conceive, many women can become pregnant with the right treatment and intervention. Knowing the signs of endometriosis and how it impacts fertility can help you make informed decisions during your family planning journey.
Related: Learn about other causes of infertility in women.
What is Endometriosis?
Endometriosis occurs when tissue similar to the lining of the uterus grows outside of the uterus. The endometrial tissue may grow on the ovaries, fallopian tubes, and on other structures such as the bladder or intestines.
Common symptoms of endometriosis include:
Chronic pelvic pain
Severe cramping
Heavy menstrual bleeding
Painful intercourse or bowel movements
Fertility challenges
Diagnosis of Endometriosis
Endometriosis often goes undiagnosed as its symptoms overlap with other conditions, and diagnosis typically requires surgery. Those experiencing pelvic pain might understandably hesitate to undergo surgery unless medically necessary. These factors can delay diagnosis.
If your physician suspects you may have endometriosis, they may ask questions about your personal and family medical history, perform a pelvic exam, and recommend a surgical procedure called laparoscopy. During laparoscopy, your doctor can look for endometriosis and, if found, remove endometrial tissue causing scarring or inflammation.
If endometriosis is found during laparoscopy, your doctor will evaluate the severity:
Stage 1: Minimal
Stage 2: Mild
Stage 3: Moderate
Stage 4: Severe
In certain cases, endometriosis can also be diagnosed through ultrasound or MRI. Your doctor will help you determine the right method of diagnosis for you.
How Endometriosis Affects Fertility
The direct impact of endometriosis on fertility is still being studied. Traditionally, physicians believed that endometrial scarring damaged the fallopian tubes, preventing fertilization. In other words, the scar tissue prohibited sperm from reaching the egg.
Now, it’s suspected that the inflammatory effect of endometriosis impacts egg quality, quantity, and reproductive function. Endometriomas, or ovarian cysts, may also reduce ovarian reserve.
Regardless of the relationship between endometriosis and fertility, there are many treatment options that can help women with endometriosis successfully conceive.
Treatments for Managing Endometriosis and Improving Fertility
Some women with endometriosis can conceive without intervention. For others, timely diagnosis and intervention are important. While intervention can include surgery, not all treatments for endometriosis are surgical. Your doctor may recommend some of these strategies to mitigate pain and improve fertility.
Lifestyle Changes
Endometriosis is a chronic condition, which means that there’s no permanent cure. However, certain lifestyle modifications can improve your chances of conceiving and help you feel better.
Nutrition is an important factor. Your doctor might recommend an anti-inflammatory diet to combat the inflammatory response of endometriosis. For example:
Eat plant-based foods
Avoid meat consumption
Increase fiber intake
Increase vitamins C, D, and E intake
Medications
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as Ibuprofen, may be used to help with pain from endometriosis.
Hormone therapy can also reduce pain by decreasing the thickness of endometrial tissue. This is an option for women who are not looking to become pregnant soon. Hormone therapy includes:
Birth control pills containing estrogen and/or progestin
Hormone injection
Intrauterine device (IUD)
Another option is GnRH agonists, which reduce estrogen and stop the menstrual cycle. Each of these medications may help reduce pain, but will not address fertility issues.
Surgery
Laparoscopy isn’t only used to diagnose endometriosis. This surgical procedure is also used to remove or reduce endometrial growths, cysts, and adhesions (scar tissue). Removing endometrial and scar tissue can often improve fertility outcomes while also reducing pain.
Fertility Treatments
Every woman, and every case of endometriosis, is different. Your physician may recommend a fertility assessment to evaluate ovarian reserve, as well as in vitro fertilization (IVF) or intrauterine insemination (IUI) to improve your chances of becoming pregnant.
Learn More About Fertility Treatments
At Beverly Hills Reproductive Center, we’ve helped many women with endometriosis grow their families and make informed decisions about their reproductive health. Hear from our patient, Emily:
“I have PCOS and Endometriosis and was encouraged to freeze my eggs in my 20's. My OBGYN referred me to Dr. Akopians and I am so thankful. She is hands on and makes herself available 24/7, not to mention her nurse is there for you every step of the way. I was terrified of side effects, but she managed & monitored me so closely and I had an incredible outcome.”
Women with endometriosis can often become pregnant with the right interventions. Request a consultation to learn how we can help.