How does endometriosis affect fertility, and when to seek help?

Endometriosis can affect fertility in several ways, including inflammation around the ovaries and tubes, changes that can interfere with egg quality or ovulation, and scarring that can impair tubal pickup and transport. It may also impact implantation, and some patients experience a longer time to pregnancy or pregnancy loss. Importantly, many people with endometriosis do conceive—fertility impact varies widely by disease location, severity, age, and overall reproductive health.

In general, we recommend reaching out for a fertility-focused evaluation if you’ve been trying to conceive for 12 months without success (or after 6 months if you’re 35 or older). It’s also reasonable to contact our team sooner if you have severe pain, known or suspected ovarian endometriomas, prior pelvic surgery, irregular cycles, or a history suggesting tubal factor issues. Depending on your goals and findings, next steps may include clarifying anatomy and ovarian reserve, planning targeted excision when endometriosis is distorting pelvic function, and coordinating with fertility care such as ovulation induction or IVF when appropriate.