Getting pregnant with endometriosis is very possible for most women. While endometriosis may make it harder to conceive on your own, your chances of getting pregnant with endometriosis can be high, depending on the severity of your condition, age, overall health, and treatment options.

Symptoms and conditions play a key role in diagnosing endometriosis, but when it comes to mapping out your treatment plan, a specialist will consider two important questions:

  • Are you experiencing pain from endometriosis?
  • Are you trying to conceive?

While surgery can be helpful in alleviating pain, we have to be careful not to continue to operate every time a cyst develops, because, with each excision to the ovary, we are also losing healthy eggs. Also, additional surgery does not increase the chances of pregnancy after IVF.

Since endometriosis can take many forms, and the success rates of treatments vary, your doctor will outline your best treatment options with an individual plan for you.

I have pain, and I’m trying to get pregnant

We recommend seeing a fertility specialist. As women age, treatment options tend to narrow — even if your endometriosis is mild — so we suggest seeking help sooner rather than later. With proper counseling and care, the chances of getting pregnant with endometriosis are high for most women.

The first step prior to treatment is to complete a full infertility work-up. With this testing, we can identify any other potential fertility challenges.

If you are trying to get pregnant, the best way to treat pain from endometriosis is with surgery. Patients who were previously taking any hormonal medications to manage pain must stop prior to receiving treatment. Endometriosis surgery, which is usually carried out with laparoscopic surgery, is an effective way to alleviate pain. However, depending on where your endometriosis is present, surgery can negatively affect your ovarian reserve.

Seeking help from a fertility specialist prior to such a decision can help maximize the chances of pregnancy after surgery. Following surgery, fertility treatment is a smart way to expedite pregnancy, with medication like clomiphene citrate (Clomid or Serophene) and/or intrauterine insemination (IUI), or in vitro fertilization (IVF).

 The good news is that once a woman is pregnant, her pain from her endometriosis usually subsides during the pregnancy itself.

I have no pain, and I’m trying to get pregnant

The diagnosed stage of endometriosis does not always correlate to the degree of pain women experience. Some women only have infertility as a consequence of endometriosis and do not have any pain at all.

For these women, the benefit of surgery is less clear, but fertility treatment can be very helpful. This could be either medication to stimulate the ovaries combined with an intrauterine insemination (IUI) or in vitro fertilization (IVF).

I have pain, but I’m not trying to get pregnant yet

Two of the most common ways to treat endometriosis are with medications or surgery.

If you’re not trying to get pregnant yet, your gynecologist can prescribe a variety of hormonal medications that can help alleviate endometriosis pain. If medications are unsuccessful, you may want to consider having laparoscopic surgery. A laparoscopy is an outpatient surgical procedure in which your doctor uses a narrow fiber-optic telescope inserted through an incision near your navel to look for — and sometimes remove — scar tissue or endometrial tissue blocking the Fallopian tubes.

We recommend pursuing surgery in the hands of a surgeon or gynecologist who is experienced in endometriosis and laparoscopic surgery in general. While laparoscopy can help reduce the pain from endometriosis, it can also negatively affect your ovarian reserve.

Pursuing egg freezing before endometriosis surgery is a smart way to preserve your current fertility for future family-building options. In case surgery negatively impacts your ovarian reserve, you have peace of mind that your healthiest eggs were cryopreserved beforehand.

Over time, your egg count will decrease, and endometriosis does tend to worsen. Many patients are now choosing to proactively freeze their eggs in the event that their endometriosis threatens their future fertility. This is a conversation to have with a fertility specialist who can best guide you in your decision-making process.

Take control of your endometriosis

Watching our Getting Pregnant with Endometriosis on-demand webinar to learn more about the causes and symptoms of endometriosis and the fertility treatment option available to help you conceive. With proper counseling and care, the chances of getting pregnant with endometriosis are high for most women.

Whether you’re actively trying to get pregnant, or simply looking to manage your endometriosis pain and have children in the future, a fertility specialist can support your goals with a treatment plan tailored especially for you.

Editor’s Note: This post was originally published in March 2016 and has been updated for accuracy and comprehensiveness as of March 2022.