Endometriosis and Infertility

You may have heard that endometriosis and infertility are frequently linked. Sometimes tagged as “the most under diagnosed disease of women", it’s estimated that a third of women who are infertile have endometriosis. About a third of women with endometriosis struggle with infertility.

Symptoms of endometriosis
Endometriosis occurs when endometrial tissue, which normally lines the uterus, is found elsewhere in the body. This tissue starts to act just like normal uterine tissue and during menstruation the tissue starts to bleed and break down. As this happens, scar tissue starts to form, usually in the pelvic region. The scar tissue can then lead to potential problems with endometriosis and infertility.

When scar tissue forms in the fallopian tubes the tubes may become blocked. This blockage is one of the primary reasons that endometriosis and infertility are connected, as sperm is prevented from reaching the egg for fertilization. Also, when the fallopian tube is blocked, the sperm can reach the egg to fertilize it, but the egg will not move properly down the fallopian tube. This can result in an ectopic (tubal) pregnancy.

Some women with endometriosis and infertility have high prostaglandin levels and more peritoneal fluid than normal women. This can also cause problems within the fallopian tubes and with implantation.

Endometriosis may cause luteal phase defects. Many women with endometriosis and infertility have low progesterone levels, and/or their uterine lining doesn’t build itself up normally in the post-ovulation phase. Both of these situations can cause the egg to have trouble implanting in the uterus and can increase your risk of miscarriage and infertility.

Who is at risk?
Most women with endometriosis are over age 30, but endometriosis can start developing as soon as you start to menstruate. Other risk factors for endometriosis include:

  • Having a menstrual cycle less than 28 days
  • Bleeding more than 5 days
  • Painful periods
  • Infertility
  • Congenital abnormality of the uterus
  • Abnormally tight cervical opening
  • Family history of endometriosis

Treatments for endometriosis
If you think you might have endometriosis, talk to your doctor. After a pelvic exam and other tests, a physician can determine if you have endometriosis. Your doctor may prescribe medication, surgery, or a combination of the two.

Unfortunately endometriosis is very difficult to diagnose and treat and there is no cure. Endometriosis can last for years, but some women find that surgical and medical treatments help to reduce the symptoms. 

Some women with endometriosis report that their endometriosis symptoms improve during pregnancy but endometriosis symptoms often return later in life. Some women find that their endometriosis symptoms get better after they go through menopause.

If you are infertile and have not been checked for endometriosis, talk with your doctor.

Ask a doctor in your area about endometriosis

  • American Congress of Obstetricians and Gynecologists. Endometriosis. 
  • U.S. Department of Health and Human Services. Endometriosis. 
  • Womenshealth.gov: Endometriosis. 
  • NIH Medline Plus. Endometriosis. 
  • American Pregnancy Association. Endometriosis. 
  • American Society for Reproductive Medicine. Endometriosis: Does It Cause Infertility?