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.
3 minute read
Read moreMiscarriage
Related Posts
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.
Does endometriosis increase miscarriage risk, and by how much?
Meta-analyses suggest a modest increase in first‑trimester miscarriage with endometriosis, with relative risks around 1.2–1.7 depending on natural conception versus ART. In absolute terms, most pregnancies still succeed; for example, a baseline risk near 15–20% may rise by several percentage points. Individual risk varies with age, prior losses, and coexisting adenomyosis.
How does adenomyosis affect miscarriage risk?
Adenomyosis is linked with higher rates of early loss and obstetric complications, likely from altered uterine contractility and inflammation affecting implantation. Pre‑treatment strategies such as prolonged GnRH down‑regulation before IVF or carefully selected adenomyomectomy may improve outcomes in specific cases. Discuss individualized options within the context of Adenomyosis and planned conception path.
When should I get a workup after miscarriage, and what is typically checked?
Evaluation is generally recommended after two consecutive first‑trimester losses or any second‑trimester loss. Workup often includes uterine cavity assessment for polyps, septum, or fibroids, antiphospholipid antibody testing, thyroid function, and sometimes parental karyotypes; thrombophilia testing is reserved for select cases. Imaging choices connect with Imaging & Diagnosis (MRI, Ultrasound) and fibroid care with Fibroids.
Can treating endometriosis lower miscarriage risk or just help me conceive?
High‑quality data consistently show that treating endometriosis—especially excision—can improve the chance of conceiving, while direct effects on miscarriage risk are less certain. For adenomyosis, targeted approaches (medical down‑regulation before IVF or surgery in selected patients) may reduce loss risk by improving implantation conditions. Decisions are individualized, balancing fertility goals, symptoms, and surgical candidacy.
Should I use progesterone or baby aspirin to prevent miscarriage?
Progesterone is standard after IVF and may help people with early bleeding and a history of prior miscarriages; routine use for everyone is not proven. Low‑dose aspirin or heparin is recommended for antiphospholipid syndrome but hasn’t shown benefit for unexplained losses. Your clinician can personalize use based on prior history, conception method, and results of evaluation; see related planning in IVF & ART and Pregnancy.