Conceiving with Endometriosis

Because the symptoms of endometriosis are often nonspecific, it can take many years to get a definitive diagnosis. The first step is a detailed conversation with your gyneacologist or one of our fertility specialists about your medical history and symptoms. An ultrasound examination can provide initial indications of endometriosis, but not always. If we find evidence of endometriosis, we will refer you to an endometriosis center. A definitive diagnosis is usually made through laparoscopy, during which endometriosis lesions, adhesions or scar tissue can also be removed.

Sometimes, endometriosis lesions can be visible on a transvaginal ultrasound, especially if they are located in the ovaries (known as endometriomas). However, smaller lesions or those located deep within the tissue are often not detectable. In these cases, a laparoscopy or an MRI is more suitable for diagnosis.

Yes, many women with endometriosis can get pregnant. However, the condition can affect fertility, and it may take longer to conceive. For many women, assisted reproductive technologies like IVF can improve their chances of pregnancy.

The likelihood of getting pregnant varies depending on the severity of the endometriosis. Studies suggest that women with endometriosis have about a 30-50% lower chance of conceiving naturally within a year compared to women without endometriosis.

Endometriosis can affect fertility in several ways, impacting the function of the reproductive organs and implantation:

• Adhesions and scarring can block the fallopian tubes or restrict the movement of the fallopian tubes and ovaries.

• Inflammation in the abdomen can affect egg quality and embryo implantation.

• Hormonal changes can disrupt ovulation.

In cases of moderate or severe endometriosis, IVF or ICSI is often recommended to bypass physical impairments such as adhesions or scarring of the internal reproductive organs. In some cases, the chances of success increase if laparoscopic surgery has been performed prior to in vitro fertilisation.

Whether endometriosis can lead to a miscarriage is not definitively clear. A 2023 study found that women with endometriosis had a slightly increased risk of miscarriage (18.9% vs. 17.3%). Similarly, women with endometriosis were more likely to have more than one miscarriage than women without the condition. Additionally, another study shows that women with endometriosis are three times more likely to experience ectopic pregnancies.

If you've been diagnosed with endometriosis but aren't experiencing pain and have conceived spontaneously or are trying to conceive naturally, surgery isn't necessarily required. However, if you're experiencing pain that affects your quality of life and/or you're struggling with infertility, you should consider the possibility of surgical treatment.

There are no specific dietary recommendations for endometriosis. A healthy, balanced diet with plenty of fruits, vegetables and whole grains can help reduce inflammation and improve overall well-being. Some women report that avoiding certain foods like red meat, dairy or gluten improves their symptoms, but this varies from person to person.