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Endometriosis Explained: How It Impacts Your Fertility Journey

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Last updated: October 18, 2025

Overview

Endometriosis affects nearly 10% of the female population globally during their reproductive years, yet the symptoms still remain hidden or are misdiagnosed most of the time. Women need to understand the impact of endometriosis on their reproductive health when they decide to get pregnant.

This article aims at empowering women with information and resources for their endometriosis journey, including proper diagnosis, cutting-edge treatment, and ongoing care, as well as to support them emotionally and psychologically through the condition’s challenges.

What is Endometriosis?

Endometriosis is a disorder in which the tissue that closely resembles the lining of the uterus (endometrium) starts growing in the areas outside the uterus, such as ovaries, fallopian tubes, or pelvic cavity. Similar to the normal endometrial lining, this tissue thickens, breaks down, and bleeds during a monthly cycle. However, because the tissue and blood are outside the uterus, they are unable to exit the body, which leads to scar tissue (adhesions), inflammation, and the development of cysts.

One of the main causes of infertility and persistent pelvic discomfort in women is endometriosis. Although a few women with insufficient handling can have trouble in giving birth, a vast majority of them, with good management, will still be able to conceive naturally or use fertility assistance.

Types of Endometriosis

Endometriosis is a condition that can be classified into different types based on the affected area and disease severity. The main types of endometriosis are:

  • Superficial Peritoneal Endometriosis : This is the most common type of endometriosis, in which small lesions or implants can be seen on the peritoneum or pelvic organs’ surfaces: ovaries, fallopian tubes, and the peritoneum (the lining of the pelvic cavity).
  • Ovarian Endometrioma : Also known as endometriotic cysts, "chocolate cysts," or fluid-filled cysts on the ovaries, these cysts are caused by endometrial tissue implanting on the ovary, which has been gradually filling it with menstrual blood.
  • Deep Infiltrating Endometriosis : Deep infiltrating endometriosis is characterized by the extension of endometrial tissue under the peritoneum. The tissue attaching to the bladder, bowel, rectum, or pelvic sidewall is the surrounding structure.
  • Rectovaginal Endometriosis : Rectovaginal endometriosis involves the penetration of endometrial tissue into the rectum and/or vagina. This category of endometriosis can cause painful bowel movements, pain during intercourse, and rectal bleeding.

Each type may affect fertility differently, depending on where the lesions are and how severe they are.

Symptoms of Endometriosis

There are many signs of endometriosis, but pain is the most common. The pain can be very strong or relatively mild. Symptoms typically worsen just before or during your period due to the inflammation that the hormonal changes at this time bring about. Symptoms of endometriosis include:

  • Painful periods (dysmenorrhea) : Severe cramps that start before and continue through menstruation.
  • Heavy or irregular bleeding : This may include spotting beyond periods.
  • Tiredness, bloating, or feeling sick : It is especially common during monthly flow.
  • Difficulties with conception : That is due to inflammation, scarring, or issues with ovulation.

If these signs occur often and restrict your daily life greatly, contact a gynaecologist.

Causes and Risk Factors

Although the specific cause of endometriosis is unknown, experts believe that several factors likely play a role in its development. The following are some of the primary causes and risk factors associated with endometriosis:

  • Retrograde Menstruation
    It is a condition in which menstrual blood flows back through the fallopian tubes into the pelvic cavity, allowing endometrial cells to adhere and proliferate outside the uterus.
  • Genetic Predisposition
    Having an endometriosis family history means that a woman is more likely to have this condition.
  • Hormonal Imbalance
    A high level of oestrogen can fuel the growth of endometrial tissue outside the uterus.
  • Immune System Dysfunction
    If the immune system is not functioning properly, it may be unable to identify and get rid of the endometrial cells that have spread to other parts of the body. Consequently, the endometrial cells can attach and multiply without control, leading to the formation of endometriosis.
  • Surgical Scars or Uterine Procedures
    Some procedures, like uterine surgeries or C-sections, may cause the detachment of the endometrial cells from the uterus.

How Does Endometriosis Impact Fertility?

One of the main causes of female infertility is endometriosis. The endometrial tissue growing in the ovary or fallopian tubes can cause inflammation, scarring, and adhesion formation, which, in turn, hamper egg release and fertilisation. In extreme situations, the tissue may move into other pelvic organs or areas outside the pelvis.

Adenomyosis, the condition resulting from tissue growing into the uterine muscle, is sometimes linked to endometriosis. Besides this, endometriosis can affect hormone levels and the immune system, and egg quality can be lowered, making embryo implantation difficult.

Research indicates that 30–50% of patients diagnosed with endometriosis suffer from infertility. The conception rate per month for healthy women is about 10–20%, while those with endometriosis may only reach 1–10%. The correct diagnosis and timely therapy can assist in restoring fertility potential.

Treatment Options for Endometriosis and Infertility

A fertility specialist will provide the finest care, taking into account your age, overall health, symptoms, and desire to become a parent.

  • Hormonal Therapy

    One of the possible side effects of hormone-based treatments is the abnormality of the menstrual cycle, as well as the decrease in endometrial tissue growth.

  • Surgical Management

    An operation via laparoscopy might be recommended to get rid of these types of scars, cysts, or bands of adhesions caused by the deep infiltrating endometrial lesions, and so waiting for a natural pregnancy will become possible again.

  • Fertility Treatments

    One of the assisted reproductive technologies (ART) such as IUI (Intrauterine Insemination) or IVF (In Vitro Fertilisation) that can help a woman to have a baby is the aforementioned. IVF, in particular, bypasses blocked tubes and improves pregnancy rates in moderate to severe endometriosis.

  • Pain Management and Supportive Care

    Most people find that a lifestyle change, lessening of stress and use of complementary therapies such as yoga or physiotherapy help them cope better with chronic pain due to endometriosis.

    Fertility specialists at Indira IVF employ cutting-edge diagnostics and tailored treatment plans that help women with endometriosis to become mothers.

Endometriosis Prevention

Although there is very little chance of preventing endometriosis due to an unidentified cause, there are various strategies, actions, and precautions that can be taken to lower the risk of the condition or at least lessen its severity:

  • Maintain a Healthy Lifestyle : Consuming a diet that includes mostly fruits, vegetables, whole grains, and lean proteins is essential. Additionally, regular exercise, good stress management, adequate sleep and abstaining from smoking are all contributing factors to hormonal balance and reproductive health.
  • Early Detection and Treatment : Recognising symptoms and seeking medical help promptly reduces the risk of complications and helps convert historical follow-ups into cases of slow disease progression.
  • Limit Exposure to Toxins : Stay away from environmental pollutants that come with plastics, dioxins, and processed foods. Use glass containers and natural cleaning or skincare products if you can.
  • Regular Gynaecological Check-ups : Regular pelvic exams and screenings help detect reproductive system health problems early and support effective health management.

Despite these measures being helpful, factors such as genetics, hormonal imbalance, and the immune system still affect the onset of endometriosis. Furthermore, regular doctor’s check-ups are essential for proper management.

Common Questions Asked

Can women with endometriosis get pregnant naturally?

 

Yes. Many women, who are mostly mildly and moderately affected with endometriosis, are able to get pregnant naturally, but some may require fertility assistance.

Does endometriosis always cause infertility?

 

No. While it can cause infertility, some women are able to achieve conception without needing treatment.

How is endometriosis diagnosed?

 

Endometriosis diagnosis is done via pelvic examination and imaging tests and sometimes the visualization of implants surgically by using laparoscopy to confirm tissue growth.

Can endometriosis come back after treatment?

 

Yes, it may still recur after a while, but the symptoms can be managed with regular follow-ups and treatment.

Can you still have endometriosis after menopause?

 

Yes, it is possible, but less common. Most women experience relief from this painful condition after menopause because oestrogen levels drop, and this condition usually depends on oestrogen to grow. But, in some cases, symptoms can continue even after menopause. This happens because the body still produces small amounts of oestrogen in fat cells, other tissues, and sometimes even the ovaries.

Does lifestyle affect endometriosis?

 

Yes. Good dietary habits, proper physical activity, and stress management are some of the ways to alleviate the symptoms and maintain fertility.

Can endometriosis be completely cured?

 

Currently, endometriosis does not have a permanent solution, though treatments can alleviate the symptoms and make fertility easier.

Endometriosis is a difficult, yet manageable disease that affects many women during their childbearing years. However, women can conquer the obstacles of endometriosis with the help of professional care and cutting-edge fertility technology at Indira IVF and have a smooth fertility journey. Our team of professionals provide the best care, support, and individualized therapy to meet each patient's maternity or parenthood goal.

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