How Endometriosis Contributes to Infertility
How endometriosis leads to infertility: pathogenesis; effects on gametes, tubes, and endometrium; and treatments—expectant care, surgery, and ART.
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Insights into how endometriosis impairs conception and what can help. Explore mechanisms, diagnostics, prognosis, and treatments—from expectant care and surgery to ART—to plan next steps and improve your chances.
Overview
Infertility is a common and often overwhelming challenge for those with endometriosis, and understanding why it happens is a crucial first step toward making informed decisions. This category explains the biological mechanisms that interfere with conception—such as disrupted pelvic anatomy, chronic inflammation, altered ovarian reserve, impaired egg quality, and changes in hormonal or immune signaling. You’ll also find guidance on what a thorough infertility evaluation should include, how to interpret key test results, and which factors meaningfully influence your chances of conceiving naturally.
We focus on evidence-based insights to help you understand timelines, prognosis, and when to seek specialist support. You’ll learn what symptoms or test findings warrant early intervention, how pain severity relates to fertility, and what role surgical treatment may play in improving natural conception rates. While IVF and other assisted options are addressed in their own dedicated category, this section gives you the clarity and foundation needed to navigate the early stages of your fertility journey with endometriosis.
Does endometriosis always cause infertility?
No. Many people with endometriosis conceive naturally, but the condition increases infertility risk depending on disease severity, inflammation, and anatomical distortion.
What infertility tests are most important if I have endometriosis?
Key evaluations often include ovarian reserve labs, pelvic ultrasound, assessment of tubal patency, semen analysis for partners, and a targeted review of symptoms and surgical history.
Can excision surgery improve my chances of conceiving naturally?
For some patients—particularly those with moderate to severe disease—restoring normal pelvic anatomy and reducing inflammation can improve natural fertility outcomes.
How long should I try to conceive naturally before seeking help?
If you have endometriosis, we recommend evaluation after 6 months, or sooner if you’re over 35, have severe symptoms, or already know you have ovarian or tubal involvement.
Does pain severity correlate with infertility severity?
Not always. Some people with minimal pain may have significant fertility-impacting disease, while others with severe pain may have fewer structural barriers to conception.