Get Pregnant With Endometriosis: Practical Steps and Expert Advice

A lot of people with endometriosis can still get pregnant, though it’s often a tougher road. Endometriosis affects fertility and sometimes makes getting pregnant take longer than expected.

Still, about 60-70% of those with endometriosis manage to conceive naturally, even if their symptoms seem pretty rough.

If you understand how endometriosis gets in the way of fertility, you can make smarter choices. There are things you can try to boost your chances, and medical treatments or fertility help if you need it, as covered by Healthline.

We’ll go through what you should know about getting pregnant with endometriosis, including tips and medical options you might want to consider.

Understanding Endometriosis and Its Impact on Fertility

Endometriosis can bring a lot of discomfort and make pregnancy harder for some women. Many notice period pain and other symptoms even before realizing it could impact their fertility.

What Is Endometriosis

Endometriosis happens when tissue similar to the uterine lining (the endometrium) grows outside the uterus. You’ll usually find these growths on the ovaries, fallopian tubes, or the outer surface of the uterus.

This tissue bleeds during the menstrual cycle just like the normal lining, but it can’t exit the body. That leads to irritation, inflammation, and sometimes adhesions—bands of scar tissue.

When adhesions form, they can bind organs together and make things worse.

Endometriosis isn’t the same as adenomyosis, which is when endometrial tissue grows inside the uterine wall instead of outside.

Symptoms and Diagnosis

The most common sign? Severe period pain. This pain often starts before your period and can stick around for days.

Other symptoms might include heavy periods, pelvic pain between cycles, pain during sex, pain with bowel movements, and sometimes trouble getting pregnant.

Doctors usually start with your medical history and a physical exam. A pelvic ultrasound can spot endometriomas (ovarian cysts from endometriosis), but small spots might not show.

Sometimes, doctors order an MRI or recommend a laparoscopy to check for growths and adhesions. Laparoscopy is a minor surgery using a camera to look directly at the tissue. Blood tests might be used, but they can’t confirm endometriosis alone.

How Endometriosis Affects Fertility

Endometriosis interferes with fertility in a few ways. It can cause inflammation or scarring on the ovaries and fallopian tubes, making it tough for egg and sperm to meet.

Adhesions can mess with pelvic anatomy and block reproductive organs.

Between 30% and 50% of women with endometriosis struggle with getting pregnant. Even so, some still conceive naturally, just with lower odds.

According to Mass General Hospital, people with endometriosis face a higher risk of infertility than those without it.

Treatments like surgery to remove adhesions, hormone therapy, or assisted reproductive techniques (think IVF) can improve fertility for many. Getting diagnosed early and starting care can help manage symptoms and support your pregnancy journey.

How Endometriosis Interferes With Getting Pregnant

Endometriosis makes getting pregnant more complicated in a few clear ways. It can mess with ovulation, block the fallopian tubes with scar tissue, and trigger inflammation that throws off reproductive hormones.

Effects on the Menstrual Cycle and Ovulation

People with endometriosis often notice changes in their periods—more pain, heavier bleeding, or both. Endometrial tissue can grow around the ovaries and disrupt the normal process of ovulation.

This makes it harder for an egg to mature and get released. Hormones that control the cycle can get thrown off, leading to irregular or skipped ovulation.

If you’re not ovulating regularly, your chances of pregnancy drop. Some women also notice severe cramps, long periods, or bleeding between cycles. These can be early signs that endometriosis is affecting fertility.

Want more details? Here’s more on how endometriosis impairs fertility.

Adhesions, Scar Tissue, and Blocked Fallopian Tubes

One of the main problems with endometriosis is that it creates adhesions and scar tissue in the pelvis. Adhesions can glue organs together and block fallopian tubes.

If tubes get blocked or damaged, eggs can’t meet sperm. Scar tissue might also pull the ovaries or uterus out of their usual spots, making pregnancy even less likely.

Sometimes, surgeons remove scar tissue, but it’s not always possible or effective. Blocked tubes are a major reason for infertility in moderate to severe endometriosis.

Blockages stop eggs and sperm from meeting and can increase the risk of ectopic pregnancy. Here’s more on endometriosis, adhesions, and fertility.

Effect on Anatomy	Impact on Getting Pregnant
Scar Tissue	Blocks tubes, traps eggs
Adhesions	Sticks organs together, misalignment
Blocked Tubes	Stops egg and sperm meeting

Inflammation and Hormonal Imbalances

Endometriosis usually causes chronic inflammation in the pelvis. This inflammation can damage tissues, eggs, and sperm.

The immune system releases substances that can mess with fertilization and embryo development. Inflammation can also disrupt the hormones that control ovulation and the uterine lining.

Hormonal imbalances might make the uterus less able to support a pregnancy, even if fertilization happens. Common signs of inflammation include pelvic pain, bloating, and fatigue.

Researchers think this chronic inflammation is a big reason women with endometriosis run into trouble getting pregnant. Hormone problems can make cycles irregular, which only makes things harder.

Treatment Options to Improve Fertility

There are several ways women with endometriosis can boost their chances of pregnancy. Treatments focus on hormone levels, removing endometriosis tissue, and supporting fertility with healthier habits.

Medical and Hormone Therapy

Doctors usually start with hormone therapy to control symptoms and try to improve fertility. Medications like gonadotropin-releasing hormone (GnRH) agonists and birth control pills lower estrogen levels, which can shrink endometriosis tissue and ease pain.

If you’re trying to get pregnant, these meds aren’t a long-term fix since they often stop ovulation. Sometimes, short courses help, and you might get a better shot at pregnancy after stopping the meds.

Fertility drugs like clomiphene citrate can help the ovaries release eggs. If hormone therapy doesn’t work, doctors might suggest assisted reproductive technology (ART) like IVF.

ART usually comes up when other treatments don’t get results. More on medical treatments for endometriosis and infertility.

Surgical Treatments

Surgery is sometimes a good choice for women with moderate to severe endometriosis. Surgeons can remove or destroy endometriosis tissue, scar tissue, or ovarian cysts.

This can improve how the pelvic organs work. Laparoscopic surgery is common and comes with a shorter recovery than open surgery.

Some studies show that removing endometriosis lesions helps women with Stage III or IV disease get pregnant more often. Many women notice less pain and a better quality of life after surgery.

Doctors sometimes recommend surgery before fertility treatments to improve the chances of success. Here’s more on surgery and fertility in endometriosis.

Lifestyle Modifications

Healthy habits can support fertility and help you feel better overall. Eating a balanced diet, exercising regularly, and managing stress all matter.

Some research suggests cutting back on caffeine and alcohol helps balance hormones. Keeping a healthy weight is important, too—being overweight or underweight can mess with ovulation.

Staying away from tobacco and getting enough sleep helps with quality of life. Support groups or counseling can help you handle the emotional side of infertility.

Lifestyle changes don’t cure endometriosis, but they can make medical treatments work better and improve your daily life.

Advanced Fertility Treatments and When to See a Specialist

Women with endometriosis often run into problems trying to get pregnant because the condition can disrupt how the reproductive system works. Sometimes you really need a specialist and more advanced treatments like IVF.

When to Consult a Fertility Specialist

If you’re under 35 and have been trying to conceive for over a year, or over 35 and have tried for six months, it’s time to see a fertility specialist. Women with moderate to severe endometriosis or those who’ve had surgery for it might want to check in even sooner.

If you have other risk factors for infertility, like irregular periods or a low egg count, don’t wait. Specialists can help figure out if endometriosis—or something else—is causing problems.

At your first appointment, expect a detailed medical history, an ultrasound, and maybe some blood tests. The specialist might start with less invasive treatments or suggest moving to advanced options, depending on your age, diagnosis, and what you’ve already tried.

More info is in this guide on when to seek fertility help for endometriosis.

Role of In Vitro Fertilization (IVF)

In vitro fertilization (IVF) is a common treatment for infertility caused by endometriosis, especially when other options haven’t worked out. With IVF, doctors retrieve eggs from the woman’s ovaries, fertilize them with sperm in a lab, and then transfer an embryo into the uterus.

Doctors often suggest IVF for women who have moderate to severe endometriosis, blocked fallopian tubes, or a history of pelvic surgeries. Sometimes, IVF comes up as an option after other treatments like fertility meds or intrauterine insemination don’t lead to pregnancy.

Success rates with IVF can really depend on things like age and how severe the endometriosis is. IVF helps get around some of the barriers endometriosis creates, making it easier for eggs and sperm to connect. If you want to dig deeper, check out this role of IVF in endometriosis.

Other Assisted Reproductive Technologies

IVF isn’t the only assisted reproductive technology (ART) out there for women with endometriosis. Intrauterine insemination (IUI), where doctors place sperm directly into the uterus, sometimes works for women who have mild endometriosis and healthy tubes.

Hormone treatments can boost the chances of ovulation. Some fertility specialists might also recommend laparoscopic surgery to remove endometriosis tissue before trying ART, especially if pregnancy hasn’t happened after other attempts.

Doctors choose these technologies based on the severity of endometriosis, age, and overall health. Each treatment plan gets tailored to the person after a careful evaluation. You can see more options in this overview of endometriosis and fertility.

Achieving a Healthy Pregnancy With Endometriosis

Endometriosis can make it tough for some women to get pregnant, but plenty of people still have healthy pregnancies. Taking steps early to support fertility, manage risks, and look after mental health really matters.

Steps to Optimize Pregnancy Chances

Some women with mild or moderate endometriosis can get pregnant naturally, though up to half might have trouble conceiving. Tracking ovulation cycles and timing sex for the most fertile days can help.

Using ovulation kits or fertility apps makes tracking easier. A reproductive endocrinologist or fertility specialist can run tests to check the ovaries and fallopian tubes.

Sometimes, minimally invasive surgery like laparoscopy boosts pregnancy chances by removing endometrial tissue. If pregnancy doesn’t happen, treatments like ovulation induction or IVF might come up as next steps.

Healthy habits matter here too. Eating well, keeping a healthy weight, not smoking, and limiting alcohol all support fertility and overall health. For more info, check out these strategies for increasing fertility with endometriosis.

Managing Pregnancy Risks With Endometriosis

Pregnancy with endometriosis can bring higher risks for things like preterm birth, placenta problems, or needing a cesarean. Regular prenatal visits let the care team keep a close eye on everything.

Managing pain in early pregnancy is something to discuss with a healthcare provider, since not all meds are safe. Extra ultrasounds or tests might be needed, depending on how severe the endometriosis is.

It’s important to report any unusual symptoms, like heavy bleeding or severe pain, right away.

Mental Health and Emotional Well-being

Endometriosis can take a toll on mental health, especially when fertility struggles or pregnancy risks come into play. Emotional support really helps. Joining a support group or talking to a mental health professional can ease stress and anxiety.

Mindfulness, deep breathing, yoga, or meditation might help reduce stress and make pregnancy a bit easier. Some people find journaling or sharing their story with others in similar situations comforting.

Regular check-ins with your healthcare provider should include conversations about mood and emotional health, not just physical stuff. Taking care of mental health alongside the physical side supports a healthier pregnancy for people with endometriosis.

Frequently Asked Questions

Endometriosis can make getting pregnant harder, but many women still conceive. There are several ways to improve fertility, and a doctor can help pick what’s best for each person.

What are the chances of conceiving naturally with endometriosis?

Most women with endometriosis still get pregnant without help. Around 60% to 70% of those diagnosed can conceive naturally, even if the case is severe. You can find more info on natural pregnancy rates.

What treatments improve fertility for those with endometriosis?

Treatments that help include medication, surgery to remove endometriosis tissue, and fertility treatments like IVF or IUI. The right choice depends on age, how severe the endometriosis is, and other health issues. Early chats with a fertility specialist can really help shape the plan.

How does endometriosis affect pregnancy success rates?

Endometriosis lowers the odds of getting pregnant. About 4 in 10 women with infertility also have endometriosis. Inflammation can harm eggs or sperm or block them from meeting. You can read more about this at ACOG’s endometriosis FAQ.

Can lifestyle changes impact fertility in patients with endometriosis?

Healthy habits can help some people. Managing stress, eating well, staying active, and avoiding smoking or too much alcohol may improve things for some. Still, lifestyle changes alone won’t cure endometriosis or guarantee pregnancy.

How long, on average, does it take to get pregnant when diagnosed with endometriosis?

It usually takes longer for people with endometriosis to get pregnant compared to those without it. There’s no set timeline, but delays are common. If you’ve been trying for a year or more without success, it’s a good idea to seek fertility advice sooner rather than later.

Is there a correlation between the severity of endometriosis and the ability to conceive?

When endometriosis gets more severe, it often becomes harder to get pregnant without some kind of help.

Severe endometriosis can create more scarring or even block eggs from meeting sperm.

Still, there are people with severe endometriosis who manage to have a natural pregnancy.