Endometriosis and Infertility: Understanding Your Options

Key Points:

• Endometriosis can cause infertility in 30% to 50% of affected women due to pelvic distortion, adhesions and hormonal changes.
• Diagnosis of endometriosis involves various tests like pelvic exams, ultrasounds, MRIs and laparoscopy to identify physical signs of the condition.
• Treatment options for endometriosis-related infertility include intrauterine insemination (IUI), in vitro fertilization (IVF) and for those facing persistent challenges, surrogacy can offer an alternative pathway to parenthood involving a gestational carrier.

If you’ve been diagnosed with endometriosis, you’re likely familiar with its challenging symptoms. But for many, another significant concern emerges: infertility.

If you and your partner have been trying to conceive without success, your endometriosis could be a contributing factor. Understanding your options for family building is your next step, and we can help.

Speak with a specialist today

If you’re struggling with endometriosis and infertility or want to learn more about how endometriosis can cause infertility, keep reading.

Disclaimer: We are not medical professionals, and the advice we offer is not medically certified. You should always talk with your doctor for professional medical help.

Does Endometriosis Cause Infertility?

Yes, endometriosis can cause infertility. This often-painful disorder is a significant factor in fertility challenges for many women.

Endometriosis is a condition where tissue similar to the lining of the uterus, the endometrium, grows outside the uterus.

This misplaced endometrial-like tissue most commonly affects the ovaries, fallopian tubes and the tissue lining the pelvis, though it can appear elsewhere.

Just like the uterine lining, it thickens, breaks down and bleeds with each menstrual cycle.

However, because this tissue has no way to exit the body, it becomes trapped. This leads to a cascade of problems that directly impact fertility:

• Cyst Formation: When endometriosis involves the ovaries, it can lead to the formation of cysts called endometriomas.
• Irritation and Scarring: The trapped tissue irritates surrounding areas, eventually developing scar tissue and adhesions. These are bands of fibrous tissue that can cause pelvic organs to stick to each other, altering normal anatomy.

How Endometriosis Directly Causes Infertility

If you’re dealing with endometriosis, it’s often more challenging to become pregnant. Up to 30% to 50% of women with endometriosis may experience infertility.

The relationship between endometriosis and infertility is complex, influenced in several ways:

• Distorted Pelvic Anatomy: Adhesions and scar tissue can distort the normal anatomy of the pelvis, physically hindering the egg’s journey or sperm’s access.
• Blocked Fallopian Tubes: Endometrial-like tissue can obstruct the fallopian tubes, preventing the vital union of egg and sperm.
• Inflammation and Hormonal Changes: The condition can cause chronic inflammation within the pelvic structures. It may also alter the hormonal environment around the eggs, potentially impacting their quality and function.
• Impact on Egg and Sperm: Endometriosis can also affect fertility in less direct ways, potentially damaging sperm or the egg itself.

Despite these challenges, it’s important to note that many individuals with mild to moderate endometriosis can still conceive and carry a pregnancy to term.

However, doctors sometimes advise those with endometriosis not to delay having children, as the condition may progress and worsen over time, potentially increasing the difficulties associated with endometriosis and infertility.

How is Endometriosis Diagnosed?

To diagnose endometriosis and other conditions that cause pelvic pain, your doctor will ask you to describe your symptoms, including the location of your pain and when it occurs.

Tests to check for physical cues of endometriosis include:

• Pelvic Exam: Your doctor feels areas in your pelvis for abnormalities, such as cysts on your reproductive organs or scars behind your uterus.
• Ultrasound: This test uses high-frequency sound waves to create images of the inside of your body.
• Magnetic Resonance Imaging (MRI): This is an exam that uses a magnetic field and radio waves to create detailed images of the organs and tissues within your body.
• Laparoscopy: The main way to tell for certain if you have endometriosis is through a surgical procedure called laparoscopy, which allows the surgeon to view inside your abdomen to look for signs of endometrial tissue outside the uterus.

Are There Endometriosis Infertility Treatments?

If you have or suspect that you have endometriosis and are having trouble getting pregnant, you may want to seek the help of a fertility specialist.

Your doctor may recommend trying intrauterine insemination (IUI) or in vitro fertilization (IVF), as both are assistive reproductive technologies.

Intrauterine Insemination (IUI)

This fertility treatment is a cost-effective and simple procedure, involving sperm being inserted directly into the uterus. This procedure requires no recovery time and is generally done in a doctor’s office.

Many people who do the IUI procedure take certain fertility medications in the weeks leading up to the procedure. These medications will raise estrogen levels, so it’s possible that your endometriosis pain might increase temporarily.

In Vitro Fertilization (IVF)

This fertility treatment is a more advanced form of assisted reproductive technology. The first step involves taking hormonal medications that help stimulate the ovaries to produce eggs.

Using blood tests and ultrasounds, your doctor is able to monitor how your body responds to the medications and the growth of your eggs.

After the eggs are removed from the ovaries during an egg retrieval procedure, they are taken to a lab to be mixed with sperm to create embryos.

Once the embryos mature and are ready, they can be transferred into the uterus or frozen until a later date.

When Surrogacy Becomes an Option

For those who are still struggling with infertility through their endometriosis, or for any other reason, another option is through surrogacy.

This ART method allows intended parents to have a genetically-related child but they don’t carry the baby to term themselves.

Surrogacy combines IVF and a gestational carrier to bring a child into the intended parents’ lives.

During this process, intended parents create an embryo either on their own or through a donation process. The embryo is transferred into another woman’s uterus, where it will develop until she gives birth.

Surrogacy is a partnership, as the intended parents and surrogate will be there to support each other throughout the process, and their surrogacy professional helping mediate and provide any resources that are needed.

Making an Informed Decision About Surrogacy

Although surrogacy does provide the genetic relationship many intended parents are looking for, it’s also an emotional process.

Surrogacy is not a decision that you have to make overnight, and it shouldn’t be made quickly either.

If you’d like to learn about surrogacy and how it can be a great option for you, especially if you’re struggling with endometriosis and infertility, speak with a surrogacy professional today.