1. Home
2. Education
3. AFCC Fertility Blog
4. Endometriosis and Fertility: What You Need to Know When Trying to Conceive

Endometriosis and Fertility: What You Need to Know When Trying to Conceive

Authored and medically reviewed by Dr. Eli Reshef

Dr. Eli Reshef is a reproductive endocrinologist and fertility specialist who sees patients in Chicago and the greater Chicagoland area.

If you’ve been diagnosed with endometriosis—or suspect you might have it—you’re not alone. Millions of individuals experience this condition, and while it can complicate your fertility journey and quality of life, there are effective options available. At Advanced Fertility Center of Chicago (AFCC), we understand how endometriosis impacts more than your daily life; it can influence your ability to conceive. That’s why we provide evidence-based, personalized care for patients navigating endometriosis and planning for pregnancy.

What Is Endometriosis and How Does It Affect Fertility?

Endometriosis occurs when tissue similar to the uterine lining (endometrium) grows outside the uterus. These growths often appear on the ovaries, fallopian tubes, or other pelvic organs. Because this tissue responds to hormonal changes, it may bleed during each menstrual cycle, leading to:

• Inflammation and irritation

• Scar tissue (adhesions)

• Bothersome symptoms that can disrupt daily life (e.g., painful periods, discomfort during intercourse, painful bowel movements)

Illustration of endometriomas

Impact on Fertility

Research suggests that up to 50% of individuals with endometriosis experience infertility. Why? Several factors contribute:

• Distorted pelvic anatomy from scarring (adhesions)

• Inflammation that affects egg quality, fertilization, implantation, and pregnancy retention

• Blocked fallopian tubes, preventing sperm and egg from meeting

• Impaired implantation, making it harder for embryos to attach to the uterine lining

Importantly, the severity of endometriosis doesn’t always predict fertility challenges or severity of symptoms. Even mild cases can make conception difficult or cause significant, disruptive symptoms.

Why Early Diagnosis Matters

Early detection can significantly improve symptom management and fertility outcomes. Unfortunately, many people spend years coping with pain or unexplained infertility before receiving a diagnosis. Many women are affected by symptoms early after puberty but experience a delay in diagnosis because of their young age.

Common Symptoms to Watch For

• Chronic pelvic pain

• Painful periods (dysmenorrhea)

• Pain during intercourse (dyspareunia)

• Painful bowel movements (dyschezia)

• Bloating, fatigue, or digestive issues

• Difficulty getting pregnant

If these symptoms apply to you, tracking them and sharing details with a fertility specialist is key. At AFCC, we offer comprehensive evaluations, including:

• Advanced imaging to assess pelvic health and tubal status

• Hormonal testing for reproductive function

• Diagnostic laparoscopy, an outpatient procedure that allows direct visualization of endometriosis lesions and treatment (performed by your gynecologist or a designated minimally-invasive gynecological surgeon (MIGS))

Illustration of a laparoscopy procedure

Fertility Treatment Options for Endometriosis at AFCC

Our specialists tailor treatment plans to your unique medical history, age, goals, and stage of endometriosis. Here are the most common options:

Ovulation Induction with Timed Intercourse or IUI

For mild cases, medications that stimulate ovulation can be paired with intrauterine insemination (IUI) to increase chances of fertilization.

In Vitro Fertilization (IVF)

IVF is often the most effective treatment for moderate to severe endometriosis. By bypassing the fallopian tubes, IVF improves conception rates—especially when tubal damage or pelvic adhesions are present.

Fertility Preservation

If you’re considering surgery or managing progressive symptoms, egg freezing or embryo freezing can safeguard your future family-building options.

Collaborative Surgical Management

When surgery is recommended, AFCC partners with experienced gynecologic surgeons for diagnosing and treating endometriosis lesions. Post-surgical fertility treatment, timed and managed by a reproductive endocrinologist, often yields better outcomes.

Take the Next Step Toward Parenthood

Endometriosis may make getting pregnant more challenging—but it doesn’t make it impossible. At AFCC, our board-certified reproductive endocrinologists take a holistic approach, considering your symptoms and medical history, your family-building goals, and your response to treatment. If you’re ready to explore your options, AFCC is here to help you move forward with clarity and confidence. Schedule a consultation and start your journey toward growing your family.

See all articles