How does deep infiltrating endometriosis affect fertility?

Deep infiltrating endometriosis (DIE) can affect fertility by distorting pelvic anatomy and limiting how freely the ovaries, tubes, and uterus can function. When disease involves areas like the uterosacral ligaments or the rectovaginal space, inflammation and scarring may contribute to pain with sex, reduced tubal mobility, or other barriers that make conception harder—even when the ovaries are still producing eggs.

Pregnancy planning with DIE is highly individualized, and the right next step depends on your age, ovarian reserve, symptoms, and timeline. In some situations, excision surgery can help by removing disease and restoring anatomy, while in others it may make more sense to move directly toward assisted reproduction. Our team can review your imaging, history, and goals to map out a strategy that prioritizes both symptom relief and your chances of pregnancy.