Can you get pregnant with bowel endometriosis?

Yes, many people with bowel (colorectal) endometriosis can still get pregnant. Bowel involvement doesn’t automatically mean infertility, but it can be part of a bigger picture that affects conception, including pelvic inflammation, adhesions, tubal involvement, ovarian cysts, and sometimes coexisting adenomyosis.

What matters most is your overall anatomy and fertility profile: your symptoms, especially pain and bowel symptoms, age and ovarian reserve, prior surgeries, and whether disease is distorting the pelvis or affecting the tubes or ovaries. For some patients, particularly when pain is minimal, pursuing fertility treatment (often IVF) first can be a reasonable way to prioritize pregnancy while avoiding the risks and recovery time of complex bowel surgery. For others, especially with significant pain, quality-of-life impairment, or anatomy that may block normal fertility, excision surgery first may be the better step. The important caveat is that surgery can help some people but isn’t a guaranteed fertility fix.

If you’re trying to conceive and suspect or know you have bowel endometriosis, our team can help map the disease, evaluate other fertility factors (including adenomyosis), and build a plan that balances pregnancy goals with symptom control and surgical safety. If you’d like, reach out to schedule a consultation so we can talk through whether surgery first or fertility treatment first makes the most sense for your situation.