Overview
Many women with endometriosis become pregnant. The right plan depends on your age, egg reserve, the state of your tubes, your partner's sperm and how severe the endometriosis is.
Signs of endometriosis
- Painful periods that get worse over time
- Pain during or after intercourse
- Pelvic pain between periods, or pain when passing urine or stool during periods
- Difficulty becoming pregnant
Some women have no symptoms, and endometriosis is found only during fertility tests.
How endometriosis affects fertility
- Scar tissue (adhesions) that can distort or block the fallopian tubes
- Ovarian cysts (endometriomas), sometimes called chocolate cysts
- Lower egg reserve, especially with large or repeated cysts or previous ovarian surgery
- Inflammation in the pelvis that can affect eggs, sperm and implantation
Diagnosis
- History and examination
Your symptoms often point to the diagnosis. - Transvaginal ultrasound
Shows endometriomas and can suggest deeper disease. Sometimes an MRI is added. - AMH test
Checks egg reserve before any decision about surgery or IVF. - Laparoscopy
Confirms the diagnosis and can treat endometriosis at the same time, when surgery is the right choice.
Treatment when you want to conceive
- Mild endometriosis, open tubes: trying naturally for a time, or ovulation induction with IUI
- Laparoscopic surgery: to remove endometriosis or release adhesions in selected women, especially when pain is severe. Ovarian cysts are treated carefully to protect egg reserve
- IVF: often the best option with moderate or severe endometriosis, blocked tubes, low egg reserve, older age or when other treatment has not worked
Hormonal treatments that control endometriosis pain also prevent pregnancy, so they are used before or between fertility treatments, not while you are trying to conceive.
Questions about endometriosis
Can I get pregnant with endometriosis?
Yes. Many women with endometriosis conceive naturally or with treatment. Your chances depend mostly on your age, egg reserve, the state of your tubes and how severe the endometriosis is.
Should an endometrioma (chocolate cyst) be removed before IVF?
Not always. Surgery on the ovary can lower egg reserve, so the decision depends on the size of the cyst, your symptoms and your AMH. Your doctor will weigh this with you.
Does endometriosis come back after surgery?
It can. That is why the timing of surgery and fertility treatment is planned together, so you have the best chance of pregnancy soon after.
Does IVF work for women with endometriosis?
Yes. IVF is an effective treatment for endometriosis-related infertility. Results depend mainly on age and egg reserve.
