Can endometriosis cause miscarriage? Understanding Endometriosis and Its Impact on Miscarriage

Can Endometriosis Cause Miscarriage? Understanding the Condition and Its Impact

Endometriosis affects approximately 10% of women worldwide. While it is well known for causing chronic pain and infertility, its potential relationship with miscarriage is less widely recognized. This article explores the connection between endometriosis and miscarriage, drawing on current research and expert perspectives.

What Is Endometriosis?

Endometriosis is a chronic condition in which tissue similar to the uterine lining (endometrium) grows outside the uterus. These growths may appear on the ovaries, fallopian tubes, or the lining of the pelvic cavity. Like the uterine lining, this tissue thickens, breaks down, and bleeds with each menstrual cycle. Because it is displaced outside the uterus and cannot exit the body, it can lead to a range of problems.

Read more: What causes endometriosis?

How Endometriosis Develops (Pathogenesis and Staging)

The American Society for Reproductive Medicine classifies endometriosis into four stages based on severity:

• Stage I: Minimal
• Stage II: Mild
• Stage III: Moderate
• Stage IV: Severe

Staging reflects the extent, location, and depth of endometrial-like tissue growth, as well as the presence and severity of adhesions and the presence and size of ovarian endometriomas.

Common Symptoms

Some individuals with endometriosis have no symptoms. Others may experience:

• Painful periods
• Pain during intercourse
• Pain with bowel movements or urination
• Excessive bleeding
• Infertility
• Additional symptoms such as fatigue, diarrhea, constipation, bloating, or nausea

Endometriosis and Pregnancy Outcomes

Endometriosis has long been linked with infertility; studies indicate that up to 50% of women with infertility have this condition. Less is known about outcomes among those who do conceive. Emerging research suggests higher risks of certain complications, including preterm birth, cesarean delivery, and miscarriage.

Miscarriage and Endometriosis: What We Know

Miscarriage (spontaneous abortion) is defined as pregnancy loss before 20 weeks of gestation. About 10–20% of known pregnancies end in miscarriage, though the true rate may be higher because many losses occur very early—before a person realizes they are pregnant.

Possible Biological Links

• Inflammation: Endometriosis is marked by chronic pelvic inflammation, which could disrupt embryo implantation or early placental development.
• Surgical Treatment: Few clinical trials have been conducted, and they do not indicate that surgical excision reduces miscarriage risk. However, two very large databases from Sweden and Scotland suggest that removing known endometriosis may lower the risk of pregnancy loss. More research is needed.
• Hormonal Factors: Endometriosis can alter the uterine hormonal environment, which might affect early pregnancy. Further study is required to understand these effects.

Research Highlights on Miscarriage Risk

A 2020 meta-analysis published in BioMed Research International found that women with endometriosis have a significantly higher risk of miscarriage compared to women without endometriosis. The increased risk was especially notable among women who conceived naturally, rather than those with tubal infertility who conceived using assisted reproductive technology (ART).

Coping and Next Steps

Hearing that endometriosis may raise miscarriage risk can be distressing. Many women with endometriosis, however, go on to have successful pregnancies. Counseling and treatment should be tailored to the individual. In cases of repeated losses, multiple factors may be involved, and endometriosis appears to be one of the potential contributors.

Read more: Find an Endometriosis Specialist for Diagnosis, Treatment, & Surgery.

Conclusion

Endometriosis is a complex condition that can affect fertility and pregnancy outcomes. While research indicates a possible link with miscarriage, many people with endometriosis have healthy pregnancies. If you have endometriosis or suspect you may have it and are facing difficulties conceiving or experiencing pregnancy losses, consider seeking evaluation by an endometriosis specialist.