Endometriosis and pregnancy

Many people with endometriosis get pregnant, but the disease can lower the chance of pregnancy. The 2022 ESHRE guideline reports that endometriosis can be found in up to 50% of women with fertility problems. If you want to get pregnant, your treatment plan may differ from one that only aims to reduce pain, so making an individual plan with a doctor matters.

Do hormone medicines improve the chance of pregnancy?

No. ESHRE recommends not using ovarian suppression treatment to improve fertility in women with endometriosis who have fertility problems. After surgery, hormone suppression is also not recommended solely to increase pregnancy rates. These medicines can be an option for pain, but they prevent pregnancy.

Does surgery improve the chance of pregnancy?

It depends:

• In stage I and II disease, ESHRE says laparoscopic surgery can be offered as an option because it improves the rate of ongoing pregnancy.
• For ovarian endometrioma and deep endometriosis the evidence is more limited; the decision takes account of pain, age, ovarian reserve, previous surgery and preferences.
• Routine surgery before IVF is generally not recommended.

Assisted reproduction

ESHRE says that for infertility associated with endometriosis, IVF or ICSI (ART) can be done, especially if tubal function is compromised, there is male factor infertility or other treatments have failed. According to the guideline, people with endometriosis can be reassured that ART does not increase the recurrence of the disease.

When should you see a doctor?

If you have decided to try for a pregnancy, or have been trying for a while and finding it hard, share any suspicion of endometriosis with your doctor. For symptoms see the symptoms page; for general treatment options see the treatment page.