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Endometriosis – how does it affect fertility and pregnancy?

Clinical Lead for Women's Health and Bupa GP
25 February 2021

If you have endometriosis, you may be all too familiar with the symptoms that can come with it. These can range from heavy, painful periods to ongoing pain in your pelvis. But often, people first become aware of endometriosis when they experience fertility problems. This can be one of the most distressing endometriosis symptoms of all.

Here I’ll aim to answer common questions about endometriosis, fertility and pregnancy.

Can you get pregnant with endometriosis?

Having endometriosis can mean you’re more likely to have difficulties getting pregnant. The good news is that most people with endometriosis are still able to get pregnant – it may just take a bit longer than normal. But some people with endometriosis do find that they’re unable to conceive naturally.

Why can endometriosis cause infertility?

When you have endometriosis, tissue that normally lines your womb (the endometrial tissue) starts to grow in other areas of your pelvis. These can include your ovaries and lower bowel.

It’s not entirely clear why endometriosis can sometimes cause infertility. But if the endometrial tissue is growing around your ovaries and fallopian tubes, this may cause damage that affects how well they work. Even mild endometriosis can affect your fertility.

Are there treatments for infertility caused by endometriosis?

There isn’t one definite, proven treatment for infertility caused by endometriosis. But there are various options you might be able to try. If you have endometriosis and are having trouble getting pregnant, your GP should refer you to a fertility specialist. They can talk to you about treatment options. These include:

  • keyhole surgery to remove or destroy the endometrial tissue
  • assisted reproductive techniques, like In vitro fertilisation (IVF)

Different options will suit different people better. The best option for you will depend on many things. That could include:

  • how severe your endometriosis is
  • how old you are
  • whether there is anything else affecting your fertility

  • Your doctor should go through all the benefits and risks of each option with you. They should also talk about how they apply to your own situation.

    How will endometriosis affect my pregnancy?

    For most people with endometriosis, the condition shouldn’t have any negative impact on pregnancy. But some studies have found the rates of certain pregnancy and birth-related problems to be higher in people who have endometriosis. This may include a higher risk of miscarriage or complications later on in pregnancy.

    This might be a worrying thought. But bear in mind that the vast majority of people still aren’t affected.

    Some people even find that their symptoms of endometriosis improve during pregnancy. Although this isn’t always the case. If they do disappear during pregnancy, it’s likely that they’ll return afterwards. It’s worth talking things over with your doctor before you get pregnant, if possible. And if you have any concerns when you are pregnant, do talk to your midwife or doctor.

    Seeking support

    Living with symptoms of endometriosis can be a huge burden. And having fertility problems on top of this can be particularly distressing. But don’t suffer in silence. Your doctor will be able to help you work through what options might be available to you. You may also find it helps to talk to others going through similar problems. Endometriosis UK runs support groups, as well as an online forum and helpline.


    Are you struggling to cope with your endometriosis symptoms, or do you care about someone who is? The endometriosis support page on our Women’s Health Hub offers lots of expert advice and information about endometriosis, and you don’t even need to be a Bupa customer.

    Dr Samantha Wild
    Clinical Lead for Women's Health and Bupa GP

      • Endometriosis. NICE Clinical Knowledge Summaries. cks.nice.org.uk, last revised February 2020
      • Endometriosis. Medscape. emedicine.medscape.com, updated 25 July 2018
      • Endometriosis: diagnosis and management. National Institute for Clinical Excellence (NICE). www.nice.org.uk, published September 2017
      • Endometriosis. BMJ Best Practice. bestpractice.bmj.com, last reviewed 11 January 2021
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      • Berlac JF, Hartwell D, Skovlund CW, et al. Endometriosis increases the risk of obstetrical and neonatal complications. Acta Obstet Gynecol Scand 2017; 96(6):751-760. doi:10.1111/aogs.13111
      • Leeners B, Damaso F, Ochsenbein-Kölble N, et al. The effect of pregnancy on endometriosis – facts or fiction? Hum Reprod Update. 2018; 24(3): 290-299

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