How does Endometriosis affect fertility?

March is Endometriosis Awareness Month and everyone at RHG is in full support of ensuring that the voices of those affected by endometriosis are not forgotten. This is the reason we have updated our logo for the month of March to raise awareness and help end the stigma of endometriosis.

You can find a lot of information on the Endometriosis UK website, including how you can get involved and join the campaign by taking on the 1 in 10 Challenge. You may ask “why 1 in 10?”, this is because 1 in 10 women are affected by endometriosis, yet this often neglected silent disease is rarely talked about – we hope to change that!

What is endometriosis?

Endometriosis is a long-term condition where tissue similar to the lining of the womb grows in other places, such as the ovaries and fallopian tubes. Symptoms can vary, but often include pelvic / tummy pain, period pains, feeling sick and in some cases difficulty in getting pregnant.

What is endometriosis?

Does endometriosis always lead to infertility?

No. If you have been diagnosed with endometriosis it doesn’t necessarily mean that it will be impossible for you to conceive naturally. Endometriosis is classified according to severity – minimal, mild, moderate or severe – and with minimal or mild endometriosis your chances of conceiving are not too different to what they would be without it. The chances can decrease with increasing severity of endometriosis and this is because of the greater likelihood of scar tissue, known as adhesions, being present and impacting on the reproductive organs.

How does endometriosis affect fertility?

If adhesions are present, they can be responsible for distorting the pelvic anatomy and making it difficult for an egg released by the ovary to reach the Fallopian tubes, so preventing a pregnancy occurring.

What is the percentage of infertility with endometriosis?

Most research has suggested that between 25% – 50% of women found to be infertile have endometriosis and that 30% – 50% of women with endometriosis may experience some fertility issues.

What are the chances of getting pregnant with endometriosis?

The charity Endometriosis UK suggests the following as a guideline to chances of conception:

  • 100 women without endometriosis, all start trying for a baby. At the end of one year, 84 will be pregnant.
  • 100 women with minimal-mild endometriosis, all start trying for a baby. At the end of one year, 75 will be pregnant.
  • 100 women with moderate endometriosis, all start trying for a baby. At the end of one year, 50 will be pregnant.
  • 100 women with severe endometriosis, all start trying for a baby. At the end of one year, 25 will be pregnant.

It is important to remember though that there may be other factors affecting your ability to conceive in addition to the endometriosis, most notably chronological age, and that your partner’s fertility potential might also be a factor.

How is endometriosis diagnosed?

Endometriosis is typically diagnosed though a pelvic examination, endometrial assessment and ultrasound. In some cases though, particularly with severe endometriosis, a final diagnosis is made via a laparoscopy, which is a low risk, minimally invasive procedure used to examine the abdomen and check for cysts or pelvic adhesions.

How is endometriosis diagnosed?

What is the best fertility treatment for endometriosis?

The treatment of endometriosis itself will very much depend on whether the patient wishes to conceive or not and so we tailor each patient’s treatment to their individual circumstances.

Surgical treatment can be an effective route for women with endometriosis who are experiencing fertility issues. During the procedure the endometriosis is excised and any adhesions released. For some women this may be the only intervention needed to enable them to conceive naturally afterwards. For others the recommendation may be to undergo assisted conception treatment, usually in the form of IVF.

IVF is more likely to be the best treatment in cases of moderate or severe endometriosis, if there are also issues with the Fallopian tubes or if male factors are known to be contributing to the fertility problems.

It is important to note, that surgery as a treatment for endometriosis can damage healthy tissue during the intervention which can negatively affect a woman’s fertility even further. In this case, the best treatment option for patients may be egg donation.

At RHG, we have significant experience and expertise in the treatment of women with endometriosis and we frequently see patients who have gone on to successfully conceive after being diagnosed and treated for endometriosis.

If you would like to talk to one of our gynaecology and fertility experts about your chances of getting pregnant with endometriosis and how we can help, don’t hesitate to contact us and one of our patient services team will get in touch to arrange a consultation at a time to suit you.