Fertility & Reproductive Health

Evidence-based guidance on conceiving with endometriosis: miscarriage risks, pregnancy care, infertility evaluation, and IVF and ART options. Practical tips and support to help you make informed choices at every step.

IVF & ART Infertility Miscarriage Pregnancy

Overview

Endometriosis and adenomyosis can influence fertility through inflammation, scarring, altered ovarian function, and changes in the uterine environment that affect implantation. Guidance here focuses on building a realistic path to pregnancy: when to seek evaluation, what tests matter, and how to choose among trying naturally, timed intercourse or IUI, surgery, and assisted reproduction. It also addresses how these conditions relate to miscarriage risk and pregnancy care, with pointers to targeted topics like Infertility, IVF & ART, Miscarriage, and Pregnancy.

Care is individualized. Many benefit from early consultation if there’s severe pain, endometriomas, prior pelvic surgery, bowel or bladder involvement, or age-related concerns. Learn how imaging and ovarian reserve testing inform decisions, how adenomyosis may guide embryo-transfer strategies, and where surgery fits relative to fertility goals. Practical preconception steps—optimizing anemia, pelvic floor health, and anti‑inflammatory habits—can support outcomes alongside medical and surgical care. For deeper dives on imaging, see Diagnostics & Imaging, and for uterine factors, see Adenomyosis.

When should I seek a fertility evaluation if I have endometriosis or adenomyosis?

General guidance is after 12 months of trying under age 35 and after 6 months at 35 or older. With known disease, severe pain, endometriomas, prior pelvic surgery, or suspected tubal issues, an earlier consult is reasonable. See Infertility for next steps.

Can surgery improve my chances of conceiving?

Excision can increase spontaneous pregnancy rates in some with minimal–mild disease by restoring normal anatomy. For deep disease or endometriomas, surgery may help symptoms and access to the ovaries but must be weighed against potential impacts on ovarian reserve; decisions are tailored to fertility goals. Explore Surgery, Excision Surgery, and Endometriomas to understand candidacy and risks.

Do hormonal treatments like birth control or GnRH improve fertility?

These therapies suppress ovulation and are not fertility treatments by themselves. They may be used strategically—such as pre‑IVF suppression for adenomyosis or to control symptoms while planning—but they don’t reliably boost natural conception after stopping. Learn more in Medical Management and IVF & ART.

What should a fertility workup include for someone with endometriosis?

Key elements often include ovarian reserve testing (AMH and antral follicle count), pelvic ultrasound and sometimes MRI to map disease, tubal patency testing if indicated, and a semen analysis for the partner. Findings guide whether to try naturally, consider IUI, plan surgery, or proceed to IVF. See Diagnostics & Imaging and Infertility for details.

How can I prepare my body before trying to conceive?

Start a prenatal vitamin with folate, address anemia or thyroid issues with your clinician, and aim for regular movement and restorative sleep. An anti‑inflammatory eating pattern and gut support can help symptom control and overall health, and pelvic floor therapy may improve comfort with intimacy. See Nutrition, Gut Health, and Pelvic Floor PT.