Can Endometriosis Cause Infertility? What You Need to Know

By the Endometriosis Alliance

Endometriosis affects millions of people — and for many, the impact goes far beyond pain. One of the most heartbreaking challenges faced by patients is infertility.

But how exactly does endometriosis affect fertility? What are your options? And where can you turn for support?

Let’s break it down — with compassion, science, and clarity.

How Endometriosis Affects Fertility

Endometriosis can interfere with fertility in several ways, depending on the severity and location of the disease.

• Anatomical Disruption: Adhesions and scar tissue from endometriosis can distort the pelvic anatomy, blocking the fallopian tubes or restricting egg release from the ovary.
• Inflammation: Chronic inflammation in the pelvis can damage sperm, eggs, or embryos, and may affect implantation.
• Hormonal Imbalance: Endometriosis may disrupt the hormonal signals that regulate ovulation and menstruation.
• Egg Quality: Some research suggests that long-term inflammation or cysts (like endometriomas) may reduce ovarian reserve or affect egg quality.

These factors can make it harder to conceive naturally — but that does not mean pregnancy is impossible.

Endometriosis and IVF: What the Research Shows

In-vitro fertilization (IVF) is a powerful option, especially for patients with blocked tubes or advanced-stage disease. However, studies show that untreated endometriosis may lower IVF success rates, particularly in cases involving:

• Endometriomas (ovarian cysts)
• Severe adhesions
• Chronic pelvic inflammation

Some patients benefit from excision surgery before IVF, which can improve pain and pregnancy outcomes, especially in moderate to severe disease.

What About Excision Surgery?

Excision surgery is the gold standard for both diagnosis and treatment of endometriosis — and it plays a crucial role in fertility care.

• It restores normal anatomy
• Reduces inflammation
• Preserves the uterus and ovaries
• Allows for full pathology review

While not every patient requires surgery before trying to conceive, for many, it dramatically improves their chances.

Your fertility plan should be tailored to your body, symptoms, and goals — with collaboration between a fertility specialist and a skilled excision surgeon.

Emotional Impact: The Hidden Weight of Infertility

Infertility is more than a medical condition — it’s an emotional journey.

Endometriosis patients often feel invisible or overlooked in standard fertility care. Add years of dismissal, pain, and medical gaslighting, and the process can become overwhelming.

Please remember: your feelings are valid. It’s okay to grieve. It’s okay to rest. It’s okay to ask for more answers.

Your Options, Your Timeline

Every fertility journey is unique. Options may include:

• Timed intercourse or medicated cycles
• Intrauterine insemination (IUI)
• IVF, with or without surgery beforehand
• Fertility preservation (egg freezing)
• Surrogacy or adoption
• Choosing not to pursue parenthood at all

There is no wrong path. The Endometriosis Alliance is here to support you — with resources, providers, and community, no matter where you are.

You Are Not Alone

Whether you’ve experienced a miscarriage, a failed IVF cycle, or you’re still waiting for answers, know this: you are not alone.

We see you. We believe you. And we are committed to building a future where endometriosis does not stand between anyone and the life they hope for.

Together, we rise — and we keep moving forward, one step at a time.