The lining of the uterus is known as the endometrium. This unique tissue is responsible for menstruation, including when it sloughs off and causes bleeding. This happens when you get your period.
When a person has endometriosis, tissue similar to the endometrium grows in places it shouldn’t. Examples include your ovaries, intestines, or tissue that lines your pelvis. This can cause pain and complications.
Most treatments for endometriosis aim to prevent ovulation. One example is taking birth control pills. When you’re trying to get pregnant, you’ll stop taking these treatments. Fertility in general can unfortunately also be affected by endometriosis.
Here’s what you need to know if you’re trying to get pregnant while living with endometriosis.
A 2014 review of studies found that
Fertility issues due to endometriosis can be related to several causes. The first is if endometriosis affects the ovaries and/or fallopian tubes.
An egg must travel from the ovary, past the fallopian tube, and to the uterus for fertilization before implanting into the uterine lining. If a woman has endometriosis in her fallopian tube lining, the tissue may keep the egg from traveling to the uterus.
It’s also possible that endometriosis could damage an egg or a sperm. While doctors don’t know exactly why this occurs, a theory is that endometriosis causes
Some doctors may recommend seeing an fertility specialist before you start trying to become pregnant.
A fertility specialist may conduct blood tests, such as an anti-mullerian hormone (AMH) test. This test reflects your remaining egg supply. Another term for egg supply is “ovarian reserve.”
The only way to truly diagnose endometriosis is surgery to identify areas where endometrium-like tissue is present. But these surgeries could potentially result in scarring that may affect fertility. This is usually minor, but talk with your doctor about risks and benefits.
But if you’ve had unprotected sex with your partner for 6 months and haven’t yet gotten pregnant, talk with your doctor.
If you haven’t been diagnosed with endometriosis, but are experiencing symptoms of the condition, discuss these with your doctor to see if a specialist can help.
A fertility specialist can work with your doctor to determine the severity of your endometriosis symptoms and contributing factors to your fertility issues.
Examples of treatments for endometriosis-related fertility issues include:
- Freezing your eggs: Endometriosis can affect your ovarian reserve, so some doctors may recommend preserving your eggs now in case you wish to become pregnant later. This option can be costly, and isn’t usually covered by insurance.
- Superovulation and intrauterine insemination (SO-IUI): This is an option for those who have normal fallopian tubes, mild endometriosis, and whose partner has sperm with no fertility issues.
- A doctor can prescribe fertility medications such as Clomiphene. These medications help to produce two to three mature eggs. A doctor may also prescribe progestin injections.
- A person trying to get pregnant may regularly undergo ultrasounds to ensure the eggs are at their most mature. When the eggs are ready, a doctor will insert a partner’s collected sperm.
- In vitro fertilization (IVF): This treatment involves extracting an egg from you and sperm from your partner. The egg is then fertilized outside the body and implanted into the uterus.
The success rates of IVF for those with endometriosis are about half of the success rates of those with other reasons for fertility issues. But many people with endometriosis have successfully gotten pregnant thanks to IVF treatments.
IVF is often recommended for people with moderate to severe endometriosis, or for those whose bodies haven’t responded to other treatments.
Currently, there’s no evidence that medication can improve a person’s chances of getting pregnant with endometriosis. But doctors may prescribe medications, such as progestins, to increase the amount of pregnancy hormones in the body.
It’s also important to live as healthy a lifestyle as possible when you have endometriosis and are trying to get pregnant. This can reduce inflammation in your body and prepare it to help your baby grow and thrive throughout a healthy pregnancy.
Examples of healthy steps include:
- maintaining a healthy-for-you weight
- eating nutrient-dense foods rich in fruits, vegetables, whole grains, and lean proteins
- engaging in moderate exercise on a daily basis (examples include walking, lifting weights, and participating in an aerobics class)
Keep in mind that age can be a factor for anyone wishing to get pregnant. Higher fertility rates are associated with younger age. Women ages 35 and older are at an increased risk for both fertility issues and miscarriage than younger women.
Women with endometriosis have potentially higher rates of:
- preterm delivery
- placenta previa (especially in those who had surgery to treat their endometriosis)
- cesarean deliveries
The good news is that there are many people living with endometriosis who conceive and ultimately deliver a healthy baby. The key is to start discussing your conception options, sometimes even before you think about getting pregnant.
When you’re trying to get pregnant, talk with your doctor if you haven’t conceived after 6 months of trying.