The Impact Endometriosis has on Fertility

Endometriosis can affect fertility, but it doesn’t mean that having the condition automatically means you won’t be able to conceive. While endometrial tissue growing outside the womb can sometimes interfere with reproductive organs or cause inflammation that impacts fertility, many women with endometriosis go on to have successful pregnancies.

Understanding how endometriosis might influence fertility, and what options are available, can help you feel more informed and hopeful on your journey to parenthood.

What Exactly is Endometriosis?

Endometriosis happens when the lining of the womb (endometrium) decides to grow in places it really shouldn't, like the ovaries, fallopian tubes, or even the bladder. Imagine weeds popping up in unexpected parts of a beautifully kept garden; that's somewhat like endometriosis tissue appearing outside the womb. Each month, this misplaced tissue reacts just like the lining inside the womb: it builds up, breaks down, and bleeds.

However, unlike normal menstrual bleeding that leaves the body, this internal bleeding has nowhere to go. This trapped blood can cause pain, inflammation, and scarring. Not exactly a walk in the park.

Does Endometriosis Affect Fertility?

The short answer is yes, it can, but it doesn’t mean everyone with endometriosis will struggle to get pregnant. Approximately 30-50% of women with endometriosis experience fertility challenges. 

Why Does Endometriosis Cause Fertility Issues?

There are several ways endometriosis can make fertility a challenge:

• Scar Tissue and Blockages: Endometriosis can cause sticky tissue called adhesions. These bands of scar tissue can bind organs like the ovaries, fallopian tubes, and uterus together, making it difficult for eggs to travel from the ovary through the fallopian tubes. When these pathways are blocked or distorted, it becomes harder for the egg and sperm to meet.

• Egg Quality: Those misplaced endometrial cells create ongoing inflammation in the pelvic area. This chronic inflammation can affect the quality of eggs and the environment needed for fertilisation and implantation, though researchers are still exploring the full impact.

• Hormonal Changes: Endometriosis might subtly shift your hormonal balance, influencing how and when ovulation occurs. Even small disruptions in hormone levels can throw off ovulation timing, making it trickier for the egg and sperm to connect at the right moment.

When Should You See a Doctor?

If you've been trying for a baby without luck for about a year, or six months if you're over 35, it's wise to chat with your GP. Mention any symptoms like painful periods, pelvic discomfort, or fatigue. Sometimes, women live with these symptoms for years, thinking they’re just part of life. But you don't have to put up with it.

Further Reading: Understanding Endometriosis Surgery: When is it Recommended?

Diagnosis and Fertility Checks

Your GP may recommend seeing a specialist who might suggest:

• An ultrasound to look for cysts (endometriomas)

• MRI scans for clearer pictures

• Laparoscopy (keyhole surgery) to identify and potentially remove tissue growths

The laparoscopy is both diagnostic and therapeutic, removing tissue can ease symptoms and improve fertility.

Fertility Treatments for Endometriosis

There are many treatments available for endometriosis that can help improve fertility. In addition to specific fertility treatments. These may include:

• Surgical Intervention: Removing or reducing endometrial tissue through laparoscopy can significantly increase your chances of conceiving by clearing blockages and reducing inflammation.

• IVF (In Vitro Fertilisation): When natural conception is difficult, IVF can bypass many of the obstacles caused by endometriosis by fertilising eggs outside the body and then implanting embryos directly into the uterus.

• Medication and Lifestyle Adjustments: Mild hormonal therapies, changes to your diet, and effective stress management can also play a role in improving fertility and enhancing overall quality of life.

Also Read: Egg Freezing 101: What to Know Before You Decide

The Emotional Side of Endometriosis and Fertility

Trying to conceive is often emotionally taxing on its own, and when you add endometriosis into the equation, it can feel even more overwhelming. It’s completely natural to experience feelings of frustration, sadness, or anger along the way.

Finding a community of people who understand what you’re going through can be incredibly comforting. Support groups offer a space to share experiences, advice, and encouragement from others who truly get it.

Remember, you’re not alone in this, many women with endometriosis go on to have successful pregnancies after getting the right support and treatment.

Practical Tips While Trying to Conceive with Endometriosis

Here are some straightforward, everyday actions you might find helpful:

• Track Your Cycle: Understanding your ovulation window can make a big difference when trying to conceive. With endometriosis, cycles can be irregular, so tracking daily, whether with an app, a journal, or ovulation kits, can help identify patterns over time. This information is also incredibly useful for your GP or fertility specialist when planning next steps.

• Maintain a Balanced Diet: Eating a nutrient-rich, anti-inflammatory diet can support hormonal balance and overall reproductive health. Cutting back on processed foods, refined sugar, and excessive caffeine may help ease endometriosis symptoms and improve your body’s chances of conception. Think colourful fruits and vegetables, whole grains, healthy fats, and plenty of water.

• Gentle Exercise: Keeping your body moving with regular, low-impact activities like yoga, swimming, or walking can reduce inflammation and improve blood flow to your reproductive organs. Plus, exercise is a natural stress-reliever, which can help support both your mental wellbeing and fertility.

  
  

Realistic Expectations and Hope

With the right awareness, care, and medical guidance, many women with endometriosis are able to have healthy, successful pregnancies.

It’s important to remember that everyone’s experience with endometriosis is different. What works for one person might not work for another, so take the time to work closely with your healthcare team to develop a plan that’s tailored to your needs, both for managing symptoms and supporting fertility. Stay informed, advocate for yourself, and don’t hesitate to lean on support systems when you need them. You’re not in this alone.