Endometriosis and Infertility: What You Need to Know

Jan 8, 2019 9:10:29 AM / by Metro OBGYN Team posted in Health Services, Infertility, Women's Issues

If you’re one of 5 million women in the United States who have endometriosis and you want to get pregnant, fear not. Many couples are still able to get pregnant with a little assistance. Discover all that you need to know about fertility and endometriosis, and we’ll also dispel some myths along the way!


Endometriosis and Fertility

If you’ve been trying to get pregnant and you haven’t been able too, you’re not alone, as up to 15% of couples have difficulty conceiving. There are many reasons why couples are unable to conceive, and it’s especially harder when a women suffers from endometriosis.

Metro OBGYN describes infertility as not being able to get pregnant despite having frequent unprotected intercourse for one year. There may be different reasons for infertility, some male and some female. With roughly one-third of infertility being female-related, one of those causes may include endometriosis-associated infertility.

Endometriosis occurs when the endometrial tissue grows outside of the endometrium (the inside of the uterus) and causes a wide range of symptoms. Endometriosis can often be a painful disorder. It’s estimated that 176 million women suffer from this disease, which means that you or someone you know may be affected by it.

Women who have endometriosis often worry whether or not they will be able to conceive. Fertility and endometriosis become an issue when the tissue growth gets in the way of reproduction.

Other causes of endometriosis-associated infertility may include:

  • Tissue overgrowth around the ovaries and fallopian tubes
  • Extreme endometrial overgrowth preventing ovulation
  • Low levels of human chorionic gonadotropin (hCG, a vital hormone that maintains a pregnancy)
  • Endometrial cysts cause lower ovary productivity

Risk Factors

Those who have endometriosis may be at higher risk for fertility issues. As endometriosis may occur on reproductive organs such as the fallopian tubes or the ovaries, these growths then halt sperm traveling to the egg or make it difficult for a fertilized egg to make its’ way to the uterus.

Some factors determine who has a higher risk of infertility and that depends on the stage of which the endometriosis has developed.

The four endometriosis stages include:

Stage I: Minimal

Stage II: Mild

Stage III: Moderate

Stage IV: Severe

Most women in stage I tend to get pregnant naturally, with roughly one-third of women able to conceive. While those in stage I or II may increase their fertility chances through minimal laparoscopic surgery, those in stage III or IV may have a harder chance at conceiving but more invasive surgery may increase those chances.

According to Endometriosis.org, “It is generally believed that 60–70% of women with endometriosis are fertile. Furthermore, about half the women who have difficulties with getting pregnant do eventually conceive with or without treatment.” So, while conceiving can be challenging for women with endometriosis, there are a few different ways that might improve the chances of pregnancy.

Infertility Treatment Solutions

There are different types of treatment options for women who have endometriosis. For those suffering from infertility and endometriosis, there are three potential solutions: surgery, In Vitro Fertilization, and hormone treatment. Treatment will depend on the severity of the endometriosis and the cause of the infertility.


Surgery is an excellent option for those wanting to conceive and cannot do so naturally due to endometriosis. Typically, surgery is minimally invasive and done laparoscopically, but that plays a big part in whichever stage of endometriosis a woman has. Those more likely to have surgery are the ones who are in later stages of endometriosis. According to a study published in the journal, Acta Obstetricia et Gynecologica Scandinavica, roughly 30 to 80 percent of women who had surgery were able to get pregnant, naturally, afterward. Although, while most can conceive naturally, some women who have surgery to remove their endometriosis may also need In Vitro programs or take hormone treatments to help improve their chances.


If natural pregnancy is no longer an option, one of the leading solutions for fertility issues is In Vitro Fertilization (IVF) programs. Most women who undergo IVF will eventually conceive. This program monitors hormone levels, checks sperm count, and examines the health of a woman’s eggs.


Hormone treatment also may lead to higher chances for pregnancy. Synthetic hormones taken for endometriosis may reduce symptoms and lead to pregnancy, depending on the type of hormone. At Metro OBGYN, we use two medications: Chlomid and Letrozole. These drugs help stimulate the release of an egg. After checking for ovulation, your provider may increase the dosage or opt for addition hormone injections.

It’s important to note that these types of hormones are slightly different than that of hormone treatments designed for endometriosis such as the pill or a vaginal hormone device which can stop pregnancy from occurring.

Dispelling Fertility Myths

While treatments may ease pain levels and aid women in getting back to a healthier life, there are also many misconceptions about endometriosis and infertility. Here are three common myths that women face when it comes to fertility and endometriosis.

Myth 1: Pregnancy will cure endometriosis.

While it is known that pregnancy may reduce the symptoms of endometriosis in some women, it is not actually a cure for the disease and may only lessen symptoms temporarily. Symptoms will typically return once the child is born, but this is not the case for everyone. Some women may also delay their symptoms by breastfeeding.

Myth 2: Endometriosis is synonymous with infertility.

For most women, when they hear the word endometriosis, they assume that also means infertile, and this is not the case. Many women can still conceive and carry children naturally or via IVF programs, even if they have endometriosis. If you are suffering from infertility, consult with your provider to understand why and the treatment options that are best for you.

Myth 3: Endometriosis on the fallopian tubes (or ovaries) causes infertility.

Many women often mistake endometriosis-associated infertility with pelvic-inflammatory-disease-associated infertility, which damages the fallopian tubes. Blocked fallopian tubes halt the egg and sperm from meeting thus leading to infertility. While some women do get endometrial tissues on their ovaries and fallopian tubes, it is far less common for there to be tubal endometriosis (tissue blocking the fallopian tubes), which does not always lead to infertility as surgery may remove the membrane and increase chances for conception.

Consult Metro OBGYN for Fertility

Roughly, 15% of couples have difficulty conceiving, so you're not alone. If you or your partner are planning on conceiving and having trouble doing so, consult with your providers at Metro OBGYN for a full evaluation.

Schedule your consultation today or get to know more about what it's like living with endometriosis below!

Pain in your Pelvic Area is NOT Normal. This free resource walks you through personal journeys of endometriosis and prepares you with the information you need in order to take action to address pelvic pain with your doctor. Download the eBook!

Metro OBGYN Team

Written by Metro OBGYN Team

Metro OBGYN is an independently owned practice that provides compassionate, convenient care across the spectrum of women's health services.


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