Can You Get Pregnant with Endometriosis?

by Jul 26, 2019

Women with endometriosis may have trouble getting pregnant, although it may not be impossible. Around 70% of women with mild to moderate endometriosis get pregnant without fertility treatment.


What is endometriosis?

Endometriosis is a disorder that the uterus lining, also known as endometrium, grows outside of your uterus. This displaced tissue grows on your ovaries, fallopian tubes, bladder, and tissue lining your pelvis, but rarely go beyond your pelvic organs.

With endometriosis, the excess endometrial tissue acts as it normally would. It thickens, sheds, and bleeds every cycle. Unlike the lining tissue in the uterus, this displaced tissue has no way to exit your body and become trapped. Cysts called endometriomas formed around ovaries. Scar tissue and fibrous tissue can cause organs to stick to each other.

Some women with endometriosis feel severe pain, especially during menstrual periods, while others have no symptoms. It most commonly occurs with women of childbearing age. If your mom or sister has it, you are more like to have it. It is linked to fertility issues. Fortunately, options for fertility treatments are available.

Symptoms of endometriosis

Symptoms of endometriosis can vary from none to severe. The primary symptom is pelvic pain, which often happens during the menstrual cycle. Although many experience cramps, those with endometriosis often report much worse pain and it gets worse over time.

The most common symptoms are:

–          Painful period

–          Heavy period

–          Pelvic pain that lasts six months or longer

–          Pain during sex

–          Pain with bowel movements or urination

–          Infertility

You may also experience fatigue, diarrhea, constipation, nausea, bleeding from the back passage.

The severity of the pain is not linked to how much disease tissue you have. You could experience severe symptoms but only mild endometriosis, or you could have plenty of endometrium with little or no pain.

What causes endometriosis?

The cause of endometriosis is unknown, but there are several possible explanations:

Retrograde menstruation

In retrograde menstruation, menstrual blood containing some of the uterus linings flows backward through the fallopian tubes, instead of out of the body. This occurs monthly in most women as a normal process, with the blood clearing the tissue out. The displaced endometrial tissues stick to the pelvic wall and organs resulting in endometriosis. It is uncertain why this occurs in only some women.

Transformation of peritoneal cells

Also known as the “induction theory”, experts believe hormones and immune system stimulated the transformation of peritoneal cells into endometrial cells. Peritoneal cells are the ones that line the inner side of your abdomen.

Embryonic cell transformation

Hormones such as Estrogen may have transform embryonic cells into endometrial cell implants.

Surgical scar

Endometrial cells may have attached to the surgical incision after C-section or other types of surgeries.

Endometrial cell transport

Endometrial cells are transported to other places in the body through the bloodstream or lymphatic system.


If any female member in your family has had endometriosis, you are more likely to be affected too. It occurs in all ethnicities but was more commonly seen in Asian women than White or African-American women.

Immune system

Women with lower immune system functions may not be able to get rid of certain tissue, which can cause endometriosis.

Environmental factor

Some toxins can affect the immune system and cause endometriosis but have not been approved in humans yet.

Endometriosis and fertility

Although endometriosis affects fertility, around 70% of women with mild to moderate endometriosis get pregnant without fertility treatment. If you have been trying to conceive with endometriosis for more than six months without success, talk to a gynecologist or a fertility specialist.

The exact link between endometriosis and infertility is not known. However, we know that the severity of the condition and the affected location tend to affect. Severe endometriosis may change your anatomy, lowering the chance to conceive, although natural pregnancy is possible even with the severe endometriosis.

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Treatment options


You may have seen many discussions on online forums about how diet links to endometriosis. The reality is that there is little research evidence shows food helps or prevents the chance of getting pregnant with endometriosis.

However, it is a good idea to keep a balanced diet for the sake of your physical and mental health. Plenty of green leafy vegetables, fiber, and protein from lean meat are good choices for you. You should stay away from high fat, high sugar, and processed food. It always helps to improve your overall well being while trying to conceive.

Hormonal treatments

Your doctor will probably start with measuring hormones in your body to prepare you to get pregnant. Diagnostics such as laparoscopy are helpful to understand what’s going on.

There are hormonal drugs that can be used to treat endometriosis. However, they often stop the production of certain hormones and prevent ovulation and menstruation. Therefor are not suitable to be used while trying to conceive.


Laparoscopic surgery to remove some endometrial tissues is an option. This surgery involves inserting a thin tube with a camera into your abdomen through a small cut in your skin. A laser or tiny pair of scissors then removes and destroys the excessive tissue.

Although the surgery is often successful, endometriosis symptoms can come back and get worse, interfering with the blood flow to the ovaries. The tissue removal can upset the hormone balance of reproductive organs. Surgery can create scar tissue which is worse than the endometrial tissue.

Managing the pain

If endometriosis caused pain hampers in your daily life, you might be taking painkillers such as non-steroidal anti-inflammatories (NSAIDs), or Codeine. You should stop taking them to prevent a bad effect on the baby if you conceive.

Assisted reproductive techniques

Assisted reproductive techniques (ART) such as Intrauterine Insemination (IUI) or In Vitro Fertilization (IVF) are often considered to increase chances of conceiving.

IUI involves placing your partner’s sperm directly into your body. Your doctor may recommend IUI if you have early-stage endometriosis. IUI is often paired with fertility drug treatment, such as Clomid and gonadotropin.

If IUI with fertility drugs is unsuccessful, IVF treatment is usually the next step. IVF treatment can increase your chances of conceiving, but it could be invasive and expensive. IVF treatment is usually suitable if you have late-stage endometriosis, over 35 years old, or have other infertility factors. The success rate of IVF treatment varies case by case.

Complications of endometriosis


Infertility is the main complication of endometriosis. For pregnancy to occur, the egg must travel through the fallopian tube and be fertilized by the sperm. Severe endometriosis deforms the anatomy around women’s wombs, blocking the egg and sperm from uniting. It also changes the chemistry and hormones, resulting in damage to the egg and sperm.


There is a strong link between endometriosis and miscarriage. One study showed that there is an increased rate of miscarriage in endometriosis-affected women. Another study showed that the increased risk of miscarriage in women with endometriosis is almost 80%. More research is needed to understand the exact underlying cause.


Endometriosis-associated adenocarcinoma can develop at a later stage of life for those with endometriosis. Another increased risk is ovarian cancer. The good news is that its lifetime risk is low to start with.

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