Endometriosis and Miscarriage: What Research Suggests
Learn how endometriosis may affect miscarriage risk, the roles of inflammation, hormones, and surgery, what current studies show, and ways to manage fertility.
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Evidence-based insights on pregnancy loss in people with endometriosis—what research shows about risk, mechanisms, and treatments—plus guidance on testing, prevention, and coping to support future fertility.
Overview
Pregnancy loss is common, and research shows a modestly higher risk in people with endometriosis. Inflammation, immune dysregulation, progesterone resistance, and uterine environment changes may contribute; the risk appears greater when adenomyosis coexists, likely due to impaired implantation and uterine contractility. Even with this increased risk, most pregnancies progress normally, and understanding personal risk factors helps tailor care and support future fertility.
Guidance centers on what raises risk and what can be modified: when to seek evaluation after one or more losses, which tests matter, and how medical, surgical, and lifestyle strategies may help. Topics include the role of progesterone in early pregnancy, when low‑dose aspirin or heparin is appropriate, and how endometriosis or adenomyosis treatment may influence outcomes. Readers also learn how ART choices intersect with miscarriage risk and when pre‑treatment can help, with links to related resources like Adenomyosis, IVF & ART, and Pregnancy for broader planning and care.
Common Questions
Can adenomyosis cause chemical pregnancies?
Adenomyosis may contribute to chemical pregnancies (very early pregnancy loss) in some patients. It can change the uterine environment in ways that may affect implantation and early embryo development, but it is not necessarily the only or most common cause.
What tests are done after two miscarriages with endometriosis?
After two miscarriages with endometriosis, we typically review your history and use pelvic imaging, often ultrasound and, when helpful, MRI. We may also evaluate thyroid function and other hormonal factors, and consider autoimmune overlap when symptoms or history point that way.
Can endometriosis cause miscarriage?
Endometriosis is associated with a modest increase in miscarriage risk, particularly in the first trimester. Most pregnancies are successful, and individual risk depends on factors such as age, pregnancy history, and coexisting adenomyosis.
Can adenomyosis affect fertility or pregnancy?
Yes, adenomyosis can affect fertility and pregnancy, although not everyone will struggle to conceive. It may interfere with implantation and is associated with higher risks of miscarriage and preterm birth, especially with more diffuse disease.