Endometriosis is a common condition that affects many people around the world. How common is it? Endometriosis impacts the lives of roughly 10% (190 million) of women during their reproductive years.

Endometriosis is a chronic disease that can cause a constellation of uncomfortable symptoms, including pain during periods, sex, and bowel movements, irregular bleeding, abdominal bloating, nausea, fatigue, anxiety, and depression. It is characterized by tissue similar to the lining of the uterus growing outside of it and implanting on other reproductive organs (fallopian tubes, ovaries, uterine ligaments),

Endometriosis can also cause infertility in 30-50% of people suffering from this condition. If you’re living with endometriosis and dreaming about starting or growing a family, you’re probably wondering how endometriosis might affect your pregnancy journey. If so, there’s good news ahead. Even if there is no absolute cure for endometriosis, there are many proven treatments aimed at controlling its symptoms, and many people with the condition become pregnant and have healthy pregnancies and babies.

How Endometriosis Impacts Fertility

Although the medical community has been conducting research and making educated guesses for years, there’s still a lot it doesn’t know about endometriosis, including its exact cause. But there’s something the medical community does know about the condition: people with endometriosis often have a more challenging time getting pregnant.

But at Tia, our team of women’s health experts is committed to helping our members manage their endometriosis with a comprehensive approach that ensures their whole health is taken into account.

For pregnancy to occur, a healthy egg must be released from an ovary and then travel through a fallopian tube to be fertilized by a healthy sperm. Next, the fertilized egg must travel to the uterus and, given the right conditions, attach itself to the wall to start developing.

Endometriosis, can make getting pregnant difficult and impact overall fertility in several ways:

• Endometriosis can cause chronic inflammation of the pelvis and pelvic organs, which creates a harsh environment for ovulation, fertilization, and implantation.
• Endometriosis can cause scar tissue that blocks the fallopian tubes and prevents an egg and sperm from uniting.
• Endometriosis (especially if it exists on the ovaries) can affect the quality of eggs released by the ovaries. It can also damage eggs and sperm after their release.
• Endometriosis can alter the environment in the uterus and prevent a fertilized egg from implanting successfully.
• Endometriosis can create a hormonal imbalance that isn’t conducive to ovulation, fertilization, and implantation.
• Endometriosis can alter the immune system in ways that affect pregnancy.
• Endometriosis can damage reproductive organs and prevent them from working properly.

In general, inflammation seems to be at the core of endometriosis and the problems it causes. Still, it’s worth repeating: Many people with mild to moderate endometriosis can still ovulate, conceive, and carry a healthy pregnancy to term. The medical community also knows that endometriosis is a progressive disease that generally progresses over time, and this is why many healthcare professionals recommend trying to have children at the earliest signs and symptoms of endometriosis.

Endometriosis and Pregnancy

If you have endometriosis and are considering pregnancy, it's a good idea to start with a visit to your healthcare provider. They can offer guidance and treatments tailored to your specific situation, which might include managing endometriosis symptoms (NSAIDs, hormonal birth control methods, GnRH agonists), assessing fertility, and exploring fertility treatments.

In the early stages of endometriosis, you might be able to get pregnant without any medical intervention. Oftentimes, at this stage, controlling symptoms is enough to get past the hurdle of endometriosis.

If you’re finding it more difficult to conceive, your doctor might recommend a laparoscopy to surgically remove endometriosis. During this simple procedure, a medical professional inserts a camera through a small incision in the abdomen to assess your endometriosis lesions and remove as many as possible.

For people who are 35 + or diagnosed with a more advanced form of the condition, your doctor might recommend the fertility medication to help trigger ovulation.

Additionally, your provider may suggest intrauterine insemination (IUI) instead of surgery. During this treatment, when ovulation occurs, your physician will place sperm into the uterus with a thin tube with the goal of improving the chances for fertilization and implantation.

If this treatment is unsuccessful or you have late-stage endometriosis, your doctor will likely recommend assisted reproductive technologies (ART) such as in vitro fertilization (IVF).

There is more uplifting news: Pregnancy can actually bring relief from endometriosis symptoms for some people.

During pregnancy, menstruation stops, which means the growth and shedding cycle that can make endometriosis worse is put on pause. Many people report a decrease in endometriosis-related pain during their pregnancy, and for some, this relief can continue after giving birth.

Pregancy is still possible with endometriosis

Every person is unique and every journey with endometriosis and pregnancy is personal. While endometriosis can make getting pregnant a challenge for some people, there is hope. Recently, there has been an uptick in attention to chronic conditions like endometriosis and the global toll these conditions can take.

Advances in treatments and a better understanding of endometriosis have made pregnancy a reality for many people who once thought it might be out of reach. Keeping an open dialogue with your doctor, staying up-to-date and informed, and leaning on your support network is paramount. But with patience, preparation, and proper care you, too, can likely navigate these challenges and start or grow your family with success.

If you’re experiencing symptoms of endometriosis and struggling to get a diagnosis and treatment plan, Tia is a good place to start. We take a holistic approach to women’s healthcare and offer a focused care for enodmetriosis to help discuss, diagnose, and manage this notoriously difficult-to-diagnose condition.