Fertility
How does PCOS affect fertility if I also have endometriosis?
The short answer
PCOS commonly reduces how often you ovulate, which can make pregnancy harder when you also have endometriosis. Endometriosis can add barriers through pelvic inflammation and scarring and, in some cases, affect the ovaries or fallopian tubes.
PCOS and endometriosis can affect fertility in different ways, and having both can create overlapping barriers to conception. PCOS commonly reduces how often you ovulate, which can make timing and achieving pregnancy harder even when the tubes and uterus are normal. Endometriosis can interfere through pelvic inflammation, scarring, and pain-related issues with pelvic floor and sexual function. In some cases, it can affect the ovaries or fallopian tubes.
The good news is that we can often make a clear plan once we identify what’s most limiting for you right now: irregular ovulation, pelvic anatomy, ovarian reserve, or a combination. Many patients benefit from a coordinated approach that supports ovulation while also addressing endometriosis when it’s contributing meaningful pelvic disease or symptoms. If age, time spent trying, or pelvic findings suggest a narrower window, our team can help you compare options like fertility medications, surgical treatment of endometriosis when appropriate, and assisted reproduction, and decide on the most efficient next step for your goals.
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Struggling with PCOS and Endometriosis?
We understand how these conditions can stack challenges to fertility. Our specialists can pinpoint the main issues and tailor a treatment plan just for you.
Questions people ask next
All fertility questionsHow does endometriosis affect fertility, and when to seek help?
Endometriosis can affect fertility through inflammation and scarring, but many people do conceive. In general, evaluation is recommended after 12 months of trying without success, or 6 months if you’re 35 or older; earlier evaluation is reasonable with severe pain or other risk factors.
Can endometriosis surgery affect fertility?
Yes, endometriosis surgery can affect fertility in both positive and negative ways, depending on where the disease is and what surgery involves. Removing disease can improve the chances of conception, but surgery on the ovaries can reduce ovarian reserve.
Do endometriomas affect fertility or ovarian reserve?
Yes, endometriomas can affect fertility and may be associated with lower ovarian reserve in some patients. Surgery, especially repeat cyst surgery, can also affect ovarian reserve because healthy ovarian tissue can be removed or its blood supply altered.
How do endometriosis stages affect fertility and treatment choices?
Endometriosis stage can influence fertility, but it doesn’t predict it perfectly, and treatment planning is individualized. Depending on age, symptoms, imaging and fertility goals, treatment may involve excision surgery, fertility treatment or both.
Further reading
PCOS Together With Endometriosis and/or Adenomyosis
Can PCOS occur together with adenomyosis or endometriosis? Yes. See how that overlap differs between the two, and what to ask about fertility and FET.
Making a Fertility Plan: Working with Your Endometriosis Care Team
Learn how to create a patient-centered fertility plan with your endometriosis care team, addressing symptoms, treatment, and desired timelines.
How Endometriosis Contributes to Infertility
How endometriosis leads to infertility: pathogenesis; effects on gametes, tubes, and endometrium; and treatments (expectant care, surgery, and ART).
