Endometriosis can make it harder to get pregnant, but it doesn’t always prevent conception.

The condition can cause:

• inflammation in the pelvis
• scar tissue or adhesions
• ovarian cysts (endometriomas).

These factors may reduce fertility, depending on their location and severity.

 

✔ Key takeaways

• Endometriosis can reduce fertility, but many people still conceive naturally.
• Your situation is unique; talk to your healthcare professional about options.

Endometriosis can impact fertility but does not always cause infertility.

Some people with endometriosis may find it harder to get pregnant because the condition can cause inflammation, scar tissue, or changes to the reproductive organs. These changes can sometimes make it more difficult for an egg and sperm to meet or for a pregnancy to implant.

However, many people with endometriosis are still able to conceive — either naturally or with support.

The impact on fertility varies depending on factors like:

• the severity of endometriosis

• where the tissue is located

• age and overall reproductive health.

It’s also important to remember that infertility can have more than one cause, and endometriosis is just one possible factor.

✔ Key takeaways

• Endometriosis can affect fertility, but it doesn’t necessarily lead to infertility.
• Many people with endometriosis have children.
• Early professional advice clarifies your fertility options.

There isn’t one best age to try for pregnancy with endometriosis, but timing can be important.

Fertility declines with age, especially after your mid-30s.

For people with endometriosis, age-related fertility decline can be greater, especially if the ovaries are affected or inflammation is ongoing.

Some people start trying for pregnancy earlier or seek advice sooner to plan their families.

It’s often recommended that you speak with a healthcare professional if you:

• are planning a pregnancy and have endometriosis
• have been trying to conceive for around 6 months without success
• are over 35 and trying to conceive.

Schedule a conversation with your healthcare team to assess your fertility, discuss your goals, and explore your personalised options—timing, treatments, or fertility preservation.

✔ Key takeaways

• There is no best age, but earlier planning can help.
• Fertility declines with age; timing matters.
• Take action now: seek early guidance to understand your options and start planning confidently.

Yes! Many people with endometriosis conceive naturally. It may take longer and more planning than for those without the condition.

Endometriosis can cause scarring, cysts, and adhesions in the pelvis. It can also impact egg quality in some people. These impacts may interfere with ovulation or fallopian tube function, which can delay conception for some people.

There isn’t a universal timeline for how long it takes to conceive naturally with endometriosis. This varies based on individual factors such as age, disease severity, reproductive health history, and other fertility factors.

However:

• many people with endometriosis do conceive without medical intervention
• endometriosis may delay natural conception, but pregnancy is often still possible.

If you have been trying to conceive naturally for about six months without success, take action now by scheduling a conversation with your healthcare practitioner to assess your next steps. Don’t wait for the typical 12‑month guideline often used for people without fertility concerns.

✔ Key takeaways

• Most Many people with endometriosis can conceive naturally, although it may be more difficult.
• Endometriosis may delay or impede conception.
• Early talks with providers help tailor your plan. 

While no lifestyle change can cure endometriosis or guarantee pregnancy, some natural approaches can support your overall reproductive health and fertility.

The following steps may help you make the most of your fertile window.

Track your ovulation

Understanding your cycle and identifying your fertile window (when you’re most likely to ovulate) can help time intercourse for the best chance of natural conception.

Tracking ovulation helps people with endometriosis understand their menstrual cycle. This can help identify when they’re most likely to conceive.

Your fertile window spans the five days before ovulation and the day of ovulation itself. Sperm can survive for up to five days. The egg is available for fertilisation for 12–24 hours.

Ovulation often occurs around 14 days before the next period. This timing can vary, particularly for those who may have irregular cycles.

You can track ovulation by:

• monitoring changes in cervical mucus, which typically becomes clear, stretchy and slippery just before ovulation
• using ovulation predictor kits (OPKs), which detect the luteinising hormone (LH) surge that precedes ovulation
• observing your basal body temperature (BBT), which rises slightly after ovulation.

Combining tracking methods, such as OPKs, mucus monitoring, and BBT, can give a clearer picture. This helps, especially when cycles fluctuate.

Maintain general reproductive fitness

Balanced nutrition, healthy weight, exercise, sleep, and stress management support reproductive health and hormone balance.

Although this does not change endometriosis itself, it helps your body prepare for conception.

Pelvic physiotherapy and pelvic health support

If you have pain during intercourse or pelvic floor tension, a specialist physiotherapist may help. They can improve comfort, reduce pain, and make intercourse easier during fertile times.

Work with your healthcare providers

Regular check-ins with your healthcare team help identify fertility factors early and check for issues like blocked tubes, severe adhesions, sperm quality, or ovulation problems.

✔ Key takeaways

• Lifestyle choices do not cure endometriosis, but they may improve reproductive health.
• Tracking ovulation and health optimises your fertility journey.
• Act early: schedule a professional assessment to clarify your timing and next steps in your fertility care.

Surgery can improve fertility for some people with endometriosis, but it depends on your individual situation.

Laparoscopic surgery is a minimally invasive operation done through small incisions using a thin, tube-like instrument with a camera. This method is commonly used to remove or treat endometriosis tissue.

This may help improve fertility by:

• removing scar tissue or adhesions that affect the ovaries or fallopian tubes
• improving the function of reproductive organs
• reducing inflammation in the pelvic area.

For people with endometriosis, surgery may increase the chance of natural conception, though factors such as stage of disease, organs impacted and other individual factors can contribute to this outcome. Fertility treatments such as IVF may also be recommended.

It’s important to know that:

• surgery does not guarantee pregnancy
• endometriosis can return over time
• in some cases, repeated surgeries may affect how full your egg ‘bank’ is at the time.

Your healthcare team helps you weigh surgery’s benefits and risks based on your symptoms, age, fertility goals, and past treatments.

✔ Key takeaways

• Surgery may improve fertility if organs are affected, but results are not guaranteed.
• Outcomes from surgery vary; it is not a guaranteed solution.
• Decide about surgery with your healthcare professional, based on your personal goals.

Consider surgery if endometriosis affects your fertility or if symptoms persist despite other treatments.

Surgery may be discussed if you have:

• moderate to severe endometriosis
• endometriomas (ovarian cysts caused by endometriosis) or adhesions (bands of tissue that can cause organs or tissues to stick together) affecting the ovaries or fallopian tubes
• been trying to conceive for around 6 months without success
• ongoing pain that impacts your quality of life.

Surgery can help improve the function of your reproductive organs and may increase the chance of natural conception for some people. However, it is not always the first step. Fertility treatments like IVF may be more suitable in some situations.

It’s also important to consider that:

• surgery carries risks, like any medical procedure
• repeat surgeries may affect your egg supply
• your age and overall fertility health play a role in deciding the best approach.

Your healthcare professional or fertility specialist can help you decide whether surgery, fertility treatment, or a combination of both is the right path for you.

✔ Key takeaways

• Consider surgery if fertility or symptoms are impacted.
• It is not always the first option. Timing and your individual situation matter.
• Choose next steps with your healthcare team.

Success rates vary depending on age, endometriosis severity, and other fertility factors.

IVF can significantly improve the chances of conception for people affected by endometriosis.

Discuss your personal prognosis with a fertility specialist to understand realistic expectations.

✔ Key takeaways

• IVF is an effective option for many people with endometriosis.
• Success depends on individual factors, but guidance from a specialist helps with planning.

Endometriosis can sometimes affect early pregnancy, but it does not always cause problems with embryo implantation or increase miscarriage risk.

Research shows that endometriosis may:

• make it slightly harder for an embryo to implant due to inflammation or changes in the uterus
• increase the chance of early pregnancy complications in some people, but many with endometriosis have healthy pregnancies.

The impact varies depending on factors like:

• the severity and location of endometriosis
• age and overall reproductive health
• whether fertility treatments like IVF are being used.

It’s also important to remember that miscarriage can have many causes, and endometriosis is just one potential factor. Talking to a fertility specialist or healthcare practitioner can help you understand your personal risks and the best strategies for conception.

✔ Key takeaways

• Endometriosis may affect implantation in some people, but many go on to have healthy pregnancies.
• The risk of miscarriage is not dramatically increased for everyone with endometriosis.
• Early guidance from a healthcare professional can support planning and improve outcomes.

Egg freezing (oocyte cryopreservation) can be a choice for people with endometriosis who want to preserve fertility for the future, but it is not necessary for everyone.

You might consider egg freezing if you:

• have moderate to severe endometriosis that could affect the number and quality of eggs you have in reserve
• are not ready to conceive now, but want to protect your fertility
• have a family history of early menopause or other risk factors for declining fertility.

Egg freezing can help by storing eggs for future use, giving you more flexibility in family planning. However, it does not guarantee a successful pregnancy and involves:

• a medical procedure to collect eggs
• possible side effects and risks from hormone stimulation
• cost and accessibility considerations.

A fertility specialist can help you decide whether egg freezing is right, considering your age, the severity of endometriosis, and overall fertility health. 

✔ Key takeaways

• Egg freezing may be considered for fertility preservation in people with endometriosis.
• It is a personal choice that depends on age, ovarian health, and family-planning goals.
• Discussing options with a fertility specialist or healthcare practitioner can help you make an informed decision.

If you have endometriosis and want to know about your chances of getting pregnant, there are tests that can help. These tests provide an estimate of how many eggs you have and how your ovaries are working.

Common tests

Anti-Müllerian Hormone (AMH) blood test

This test measures Anti-Müllerian Hormone (AMH), which gives an estimate related to how many eggs are left in your ovaries.

A higher AMH usually means more eggs, while a lower AMH may mean fewer eggs.

This test can be useful for planning when to try to conceive or consider fertility preservation.

It is important to note that this test reflects egg quantity and doesn’t provide any insight into egg quality, which is also an important aspect contributing to your overall fertility.

Ultrasound scan (Antral Follicle Count)

An ultrasound can look at the number of small egg follicles in your ovaries. Follicles are tiny sacs that hold eggs.

Counting these can give a picture of your ovarian reserve.

This test is safe and non-invasive.

Other hormone tests

Tests such as FSH (Follicle Stimulating Hormone), LH (Luteinizing Hormone), and estradiol can check how well your ovaries are working. These hormones help control your menstrual cycle and ovulation.

Medical history and cycle tracking

Your healthcare professional may ask about your periods, pain, earlier surgeries, or other reproductive health issues. This information helps them understand how endometriosis may affect your fertility.

These tests are helpful because endometriosis, or surgery for it, can sometimes reduce the number of eggs in your ovaries or affect how your reproductive system works.

Your healthcare professional or fertility specialist can explain your results and help you plan your next steps.

✔ Key takeaways

• Tests like AMH blood tests and ultrasounds can provide some insight into your fertility.
• Endometriosis and its treatments may affect egg numbers, so testing early can be useful.
• Talk to your healthcare professional or a fertility specialist for advice that fits your situation.

Not everyone with endometriosis needs to see a fertility specialist before trying to conceive. Many people with endometriosis can get pregnant naturally, even if it sometimes takes a little longer.

You might consider seeing a fertility specialist sooner if you:

• are 35 years or older and want guidance on timing or fertility testing
• have moderate to severe endometriosis or pelvic symptoms
• have irregular cycles or other reproductive concerns
• want early fertility testing, such as hormone levels, ultrasounds, or semen analysis.

A fertility specialist, together with your healthcare practitioner, can help by assessing your reproductive health, planning investigations, and advising on strategies to improve your chances of conceiving.

Early guidance can help you feel more confident about your family building‑ journey.

✔ Key takeaways

• Many people with endometriosis can conceive naturally, but some may benefit from earlier specialist support.
• Age, severity of endometriosis, and overall reproductive health influence the need for specialist review.
• Your healthcare professional or fertility specialist can guide testing, treatment, and timing to support your fertility goals.

If natural conception is difficult, fertility treatments can help.

Common options

IVF (in vitro fertilisation)

This is when doctors help an egg and sperm join together in a lab, then place the tiny embryo back into the uterus to try for a pregnancy.

IUI (intrauterine insemination)

This is when sperm is put directly into the uterus at the right time in the cycle to help boost the chance of getting pregnant.

Fertility medications to stimulate ovulation

These are medicines that help your ovaries grow and release eggs, making it easier to try for a baby.

Your healthcare team can guide the best approach for your situation.

✔ Key takeaways

• Fertility treatments can improve your chances of conceiving.
• Treatment choice depends on age, endometriosis severity, and personal goals.

Some treatments may temporarily prevent pregnancy, but most are reversible.

Surgery can improve fertility if endometriosis tissue is removed, but repeated procedures carry risks.

Hormonal therapies (like the pill, IUDs, or GnRH treatments) prevent pregnancy while in use and are usually stopped when trying to conceive.

Pain medications rarely affect fertility but should be discussed with your healthcare professional.

✔ Key takeaways

• Treatment plans can be adapted to support future pregnancy.
• Talk openly with your healthcare team about your reproductive goals.

Pregnancy does not cure endometriosis.

Symptoms may temporarily improve for some people during pregnancy due to hormone changes.

After childbirth, symptoms can return or persist, so ongoing management may still be necessary.

✔ Key takeaways

• Endometriosis may improve temporarily during pregnancy for some, but it is not a cure.
• Ongoing symptom management may be needed after childbirth.

Managing endometriosis pain while planning a pregnancy can be challenging.

Strategies include:

• pain relief medications — speak with your healthcare professional to find options that are safe while trying to conceive
• hormonal therapies — these can help control symptoms, but are usually paused when planning a pregnancy
• surgery — may be recommended in some cases to reduce severe pain or improve fertility
• lifestyle approaches — gentle exercise, regular sleep routines, stress management, and pelvic physiotherapy can all help manage symptoms
• support networks — connecting with mental health professionals and peer groups can provide emotional and practical support.

✔ Key takeaways

• You can take steps to feel comfortable and maintain daily activities while planning for a family.
• Your plan may combine treatments, lifestyle changes, and support tailored to your needs.