Endometriosis and Fertility: What You Need to Know

04 March 2026

Posted in

Women's Health

For many women, a diagnosis of endometriosis brings up a mix of emotions and a long list of questions. Topping that list is often the concern: “Will I be able to get pregnant?”

While the condition presents unique hurdles, understanding the connection between endometriosis and fertility is the first step toward managing your health and planning for the future. INTEGRIS Health is dedicated to providing clarity on the complex topics of endometriosis and fertility, helping you explore your options with confidence.

We speak to Robert Thomas, D.O., a board-certified OB/GYN at INTEGRIS Health Medical Group Women’s Miami, to learn more.

“Endometriosis can lead to inflammation, severe pain during periods and, for some, difficulties with fertility,” Thomas says. “If you suspect you might have endometriosis, schedule an appointment for a consultation with an OB/GYN.”

What is endometriosis, and how does it affect fertility

The basics: Endometriosis is a condition where tissue similar to the lining inside the uterus, the endometrium, grows outside the uterus. This tissue can be found on the ovaries, fallopian tubes and the pelvic lining. This misplaced tissue acts as endometrial tissue would. It thickens, breaks down and bleeds with each menstrual cycle. Since this tissue has no way to exit the body, it becomes trapped.

Endometriosis affects an estimated 1 in 10 women during their reproductive years.
The primary complication of endometriosis is impaired fertility.
It can also lead to cysts called endometriomas and an increased risk of certain cancers.

Endometriosis poses a challenge for conception due to several reasons. The chronic inflammation it causes is a key factor.

This inflammation can make it harder for the sperm and egg to meet or for an embryo to implant in the uterus.
In more advanced stages, scarring and adhesions can physically block the fallopian tubes or distort the pelvic anatomy, preventing the egg from traveling to the uterus.
The inflammation might also damage the DNA of oocytes, which are the unfertilized eggs in the ovaries.
Cysts called endometriomas can grow on the ovaries, potentially damaging ovarian tissue.

Mild vs. severe endometriosis and your chances of conception

The rundown: The severity of endometriosis directly impacts the likelihood of conceiving. While pregnancy is possible at any stage, the approach and potential need for medical assistance vary significantly.

Mild endometriosis may only slightly affect fertility, and natural conception is often still possible.
With moderate endometriosis, fertility challenges may arise, and some individuals might benefit from medical interventions.
Severe endometriosis significantly impacts reproductive health, often requiring advanced treatments to improve the chances of conception.

Women with minimal or mild endometriosis often have a good chance of conceiving naturally. The inflammation is less severe, and there is little to no structural damage to the reproductive organs.

For women with minimal or mild endometriosis, the monthly probability of pregnancy is slightly lower than for women without the condition, but many still conceive without intervention.
Surgical removal of endometrial lesions in mild cases can sometimes improve the chances of spontaneous conception.

In cases of moderate to severe endometriosis, significant scarring, adhesions and large endometriomas can create substantial physical barriers to conception. Natural conception becomes much more difficult.

Extensive scar tissue can block the fallopian tubes, preventing the egg and sperm from meeting.
Large cysts on the ovaries can damage healthy ovarian tissue and reduce ovarian reserve.
Surgery may be required to remove adhesions or cysts to improve the chances of pregnancy, but this must be balanced against the risk of damaging the ovaries.

Treatment options for endometriosis and fertility support

The approach: Managing endometriosis with the goal of pregnancy involves a two-pronged approach of controlling the disease and supporting fertility. Your doctor will help you decide the best path forward based on your individual circumstances.

Hormonal treatments can help manage endometriosis symptoms and may improve fertility in some cases.
Assisted reproductive technologies, such as IVF, can provide alternative options for achieving pregnancy when natural conception is difficult.
Adopting healthy lifestyle changes, including a balanced diet and regular exercise, can support overall fertility and well-being.

Hormonal therapies like birth control pills are effective for managing endometriosis pain but are not a solution for infertility because they prevent ovulation.

These treatments work by suppressing the menstrual cycle, which stops the growth of new endometrial tissue.
They are typically used to manage symptoms before a woman is ready to conceive or after she has completed her family.
Once hormonal therapy is stopped, the ability to conceive returns, but the endometriosis symptoms may also reappear.

Laparoscopic surgery is a common procedure used to diagnose and treat endometriosis. By removing endometrial implants and scar tissue, surgery can restore normal pelvic anatomy and may improve fertility.

Women with minimal to mild endometriosis can increase their chances of spontaneous pregnancy with surgery.
In severe cases, surgery can remove blockages or large cysts, making natural conception or assisted reproductive technologies like IVF more feasible.
Repeated surgeries can adversely affect ovarian reserve, so the decision to operate requires careful consideration.

IVF is a powerful tool for women with endometriosis, especially when other methods have failed or in cases of severe disease. The IVF process involves retrieving eggs from the ovaries, fertilizing them with sperm in a lab and then transferring the embryo directly into the uterus.

IVF bypasses many of the fertility obstacles created by endometriosis, such as blocked fallopian tubes and pelvic inflammation.
Success rates with IVF for women with endometriosis are generally good, although they can be influenced by age and ovarian reserve.
It’s an important option to discuss with a fertility specialist.

Find a doctor at INTEGRIS Health now

Your next step: Navigating endometriosis and fertility can feel overwhelming, but you don’t have to do it alone. The expert gynecologists and fertility specialists at INTEGRIS Health are here to provide the compassionate and personalized care you deserve.

We use the latest diagnostic tools and treatment options to create a plan that aligns with your health needs and family-building goals. Schedule a consultation today to take control of your reproductive health.