IVF guide
Endometriosis and fertility
Endometriosis is a condition in which tissue similar to the lining of the uterus grows outside the uterus. It can cause pain and may affect fertility.
What endometriosis is
In endometriosis, tissue similar to the uterine lining is found on the ovaries, the fallopian tubes, the surface of the pelvis or other organs. This tissue can cause inflammation, scarring and adhesions. Cysts on the ovaries caused by endometriosis are called endometriomas.1
Symptoms
- Painful periods
- Pain during or after intercourse
- Chronic pelvic pain
- Pain with bowel movements or urination during periods
- Difficulty conceiving1
How it can affect fertility
Endometriosis may affect fertility through adhesions and damage to the fallopian tubes, changes in the pelvic environment and, in the case of endometriomas, effects on ovarian reserve. The effect differs from person to person.1
Diagnosis
The physician evaluates the symptoms and examination findings. Ultrasound and MRI can show endometriomas and deep endometriosis. A definite diagnosis sometimes requires laparoscopy, a keyhole operation.1
Treatment options
Options include pain treatment, hormonal medication, surgery and assisted reproduction. Hormonal medication can reduce pain but does not usually help conception. Surgery on ovarian cysts may reduce ovarian reserve, so the decision is weighed carefully.1 IVF may be considered depending on age, ovarian reserve, tubal status and previous treatment.2
At a glance
- Common symptoms are painful periods and pelvic pain.
- Some women have no symptoms.
- Diagnosis may involve ultrasound, MRI or laparoscopy.
- Treatment is planned individually.
Frequently asked questions
No. Many women with endometriosis conceive naturally.1
Not always. The decision depends on size, symptoms and ovarian reserve and is made by the physician.
Yes, it can recur after treatment. Follow-up is planned by the physician.
References
- Becker CM, Bokor A, Heikinheimo O, et al. ESHRE guideline: endometriosis. Human Reproduction Open. 2022;2022(2):hoac009.
- National Institute for Health and Care Excellence (NICE). Fertility problems: assessment and treatment. NICE guideline NG257. 2026.
Related topics
This page gives general information only. It does not replace an examination, and the treatment plan is decided by the physician for each person individually.