Getting pregnant with endometriosis is 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 may be also losing healthy eggs. Also, we have learned now that 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
In this situation, we recommend seeing a fertility specialist. As women age, treatment options tend to narrow and chances of pregnancy decline, so even if your endometriosis is mild — we suggest seeking help sooner rather than later. With proper counseling and care, the chances of getting pregnant with endometriosis are good 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, you may need to stop taking some hormonal medications that manage pain, such as oral contraceptive pills. When trying to conceive, one option to treat pain from endometriosis is with surgery. Endometriosis surgery, which is often done laparoscopically, is an effective way to alleviate pain. However, depending on the extent and location of your endometriosis, surgery may negatively affect your ovarian reserve.
Seeking advice from a fertility specialist prior to undergoing surgery can help maximize the chances of pregnancy after surgery. By identifying all of the factors that can impact your fertility upfront, you can have a proactive plan that utilizes your time and efforts most efficiently. Following surgery, fertility treatment is a common way to expedite pregnancy, with medication like clomiphene citrate (Clomid or Serophene) and/or intrauterine insemination (IUI), or in some cases, 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
Some women only have infertility as a consequence of endometriosis and otherwise do not have any pain at all. While it may seem counterintuitive, the stage of endometriosis does not always correlate to the degree of pain women experience.
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 remove scar tissue consistent with endometriosis.
We recommend pursuing surgery in the hands of a 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. While not typically recommended, in certain select cases, surgery for endometriosis may also help make future egg retrievals easier.
Depending on the type and extent of surgery planned, freezing eggs beforehand may be a good strategy to preserve your current fertility for future family-building options. With egg freezing, a woman’s eggs are retrieved, frozen, and stored in our lab until a woman is ready to conceive. Frozen eggs can serve as woman’s “backup” in the event of future infertility, literally freezing her potential for pregnancy in time.
Over time, your egg count will decrease, and endometriosis often worsens. Many patients are now choosing to proactively freeze their eggs in the event that their endometriosis threatens their future fertility, regardless of whether they are facing imminent surgery. 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.
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.
Medical contribution by Andrea E. Reh, M.D.
Andrea Reh, M.D., FACOG, is board certified in obstetrics and gynecology as well as reproductive endocrinology and infertility. She was named as one of the Washingtonian’s Top Doctors (2019 – 2021), Top Doctors in Northern Virginia Magazine in 2020 and Top Doctors in Arlington Magazine in 2021. Dr. Reh sees SGF patients at the Arlington, Virginia office.
Editor’s Note: This post was originally published in March 2016 and has been updated for accuracy and comprehensiveness as of February 2023.
