Living with endometriosis can be emotionally challenging. One of the most difficult aspects is its potential impact on fertility. In the UK, an estimated 30–50% of people with endometriosis experience difficulties conceiving, and the condition is found in around 1 in 4 people being investigated for infertility. 

What is Endometriosis 

Endometriosis occurs when tissue similar to the lining of the uterus grows outside the womb, commonly on the ovaries, fallopian tubes, bowel, bladder, or pelvic lining. These growths respond to hormonal changes, which cause inflammation, scarring, and adhesions. 

Endometriosis can affect fertility by: 

• Causing inflammation 

• Endometrial tissue can cause organ adhesion, pelvic structural changes, and blocked fallopian tubes, preventing egg and sperm from meeting 

• Disrupt the release of eggs from the ovaries 

However, it’s important to remember that a diagnosis of endometriosis is not a diagnosis of infertility. 

Many people conceive naturally, while others need support such as ovulation induction, IVF, IUI, surrogacy and ovulation induction. Male infertility can also impact which of these options is used if in a heterosexual relationship.  

 

Trying to Conceive: What Helps? 

If you have endometriosis and are trying to get pregnant, options include: 

 

• Laparoscopic surgery– Endometriosis can only be diagnosed by a laparoscopy. During a laparoscopy, different procedures can be used to eliminate or remove endometriosis, treat endometriotic cysts, and free scar tissue (adhesions). 

 

• Assisted reproductive technologies (ART) – IVF, or invitro fertilisation, is a process where eggs are fertilised with sperm in a lab, and the resulting embryo is placed into the uterus to help achieve pregnancy. IUI is another fertility treatment that may be suitable for people with endometriosis. During IUI, sperm is placed directly into the uterus around the time of ovulation to increase the chances of fertilisation. IUI is commonly used for couples with unexplained infertility, mild male factor infertility, or certain cervical challenges, and it can be a less invasive first step before moving to IVF. 

 

• Lifestyle and supportive approaches – Factors like maintaining a healthy weight and reducing stress can sometimes help improve fertility. Acupuncture may also support stress reduction and overall well-being, which can be beneficial when trying to conceive. 

 

The right approach depends on: 

• Your age 

• Severity of symptoms 

• Stage and location of disease 

• How long you’ve been trying  

• Your personal preference on which treatment options you feel comfortable with  

 

Pregnancy with Endometriosis 

Some people find that symptoms improve during pregnancy due to hormonal changes, while others continue to experience pain or discomfort. 

Endometriosis does not automatically mean a high-risk pregnancy, but some studies suggest slightly increased risks of miscarriage, as well as a higher chance of giving birth prematurely. There is also a higher likelihood of developing preeclampsia, a condition involving high blood pressure and related complications. There is also a slightly increased risk of ectopic pregnancy, where the embryo implants outside the uterus, most commonly in the fallopian tubes. 

Most people with endometriosis still go on to have healthy pregnancies, especially with good medical care and monitoring. 

Post-partum and Endometriosis 

The post-partum period is a complex mix of relief and uncertainty. Some individuals experience a time when symptoms stay at bay, particularly if breastfeeding delays the return of the menstrual cycle. As hormones begin to rebalance and cycles return, many find that their previous symptoms, such as pelvic pain and heavy bleeding, reappear. Managing these physical challenges while navigating the demands of new born care is physically and mentally exhausting, making having a long-term management plan and a strong support network a necessity.   

 

Thinking About the Future 

Endometriosis is a lifelong condition, but it doesn’t have to define your future. 

 

Key things to consider: 

• Fertility preservation (like egg freezing) if you’re not ready for children yet 
• Long-term symptom management plans
• Mental health support: chronic pain and fertility stress take a real toll

  

The Emotional Side No One Talks About Enough 

Beyond the physical symptoms, endometriosis carries a heavy emotional burden that is often overlooked. It manifests as a deep grief over fertility uncertainty and a constant, low-humming anxiety about what the future holds. Many patients carry the weight of medical trauma after years of having their pain dismissed, leading to a profound sense of guilt, isolation, and eventually, total burnout. These feelings are not ‘extra’.  

A Message of Hope 

Research into endometriosis is growing. Awareness is increasing. More doctors are being trained to recognise and treat it earlier. New treatments are being explored, and most importantly, you are not alone. 

This Endometriosis Action Month 

Awareness isn’t just a hashtag; it’s the fuel for the research that will eventually find a cure. Endometriosis south coast supports people who haven’t started their diagnosis journey, are going through the diagnosis stages, or have been diagnosed with Endometriosis and/or Adenomyosis.