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If you have endometriosis (or suspected endometriosis), it’s completely normal to have concerns about your fertility and what options are available. For those exploring in vitro fertilization (IVF), you may even be wondering if an endometriosis diagnosis will impact your chances of getting pregnant with fertility treatment.
Unfortunately, the relationship between endometriosis and IVF success rates isn't always straightforward, and that can be incredibly frustrating. We’re here to break it down in a way that makes sense — including how endometriosis might affect your fertility journey and how to increase your chances of a successful pregnancy via IVF.
But first, what is endometriosis?
Endometriosis is a chronic condition where tissue similar (but not identical) to the lining of the uterus grows outside of the uterus in places like the ovaries, fallopian tubes, and other pelvic organs. This misplaced tissue swells and bleeds, just like the uterine lining, but can’t exit the body, leading to inflammation, scar tissue, and debilitating pain for some.
Women who struggle with endometriosis often deal with severe menstrual cramps, chronic pelvic pain, pain during sex, and heavy or irregular periods. And it’s so much more than physical — endometriosis can also affect your mental health, relationships, and overall quality of life.
Because knowledge of endometriosis varies, some women report feeling deeply misunderstood or dismissed by their healthcare providers, unfortunately leading to diagnosis and treatment delays. In fact, it can take an average of seven to nine years to receive a proper diagnosis.
How does endometriosis affect fertility?
Endometriosis can also make starting a family an uphill battle, with 30–50% of people with endometriosis experiencing infertility. Not only that, up to 20-25% of women with endometriosis are asymptomatic, and many cases of unexplained infertility actually turn out to be “silent” endometriosis.
Whether or not you have physical symptoms of endometriosis, it’s important to know that the condition can cause scarring and adhesions which may make it difficult for an egg to travel down your fallopian tube. Plus, the inflammation that comes with the condition doesn’t exactly provide a welcoming environment for an embryo to implant in the uterus.
Endometriosis can affect egg quality, too, but it’s not the same for everyone, says Dr. Jessica Ryniec, a double-board certified Reproductive Endocrinologist & Infertility Specialist. “Due to inflammation, endometriomas, and/or decreased blood flow to the ovaries, some [women with endometriosis] do have decreased egg quality."
So, what can you do about it?
If you’re thinking about getting pregnant in the near future, receiving a proper diagnosis is the first step to treating (and overcoming) endometriosis. This is where the ReceptivaDx test comes in — a test that can identify several leading causes of unexplained infertility in a single sample, including endometriosis, progesterone resistance, and endometritis.
A positive result (higher BCL6) means there's inflammation in your uterine lining, which is often linked to endometriosis. This information can help your OB/GYN or fertility specialist target treatment to reduce that inflammation and increase your chances of a successful pregnancy.
On the other hand, a negative result means your uterine lining looks healthy with no detected inflammation, giving you peace of mind and pointing you toward other fertility options that might be right for you.
Dr. Ryniec recommends getting a handle on your endometriosis and any inflammation before you start trying, or looking into egg freezing if you’re still a few years from starting a family. If you have trouble conceiving naturally, or if other fertility treatments don’t work, IVF becomes an option. Still, there are some things to keep in mind as you embark on this journey.
Endometriosis and IVF success rates: What to know
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Everyone’s body – like their path to parenthood — is different, and factors like the stage of endometriosis, your age, and the specific protocol used can all influence IVF outcomes.
IVF involves retrieving your eggs from your ovaries and then fertilizing them with sperm in a lab. The resulting embryos are then transferred back into your uterus. However, IVF success rates for women with endometriosis can be tricky due to its aforementioned effects on egg quality and the uterine environment. Inflammation is also a major player in how well IVF works for women with endometriosis, according to Dr. Ryniec.
Thankfully, there are ways to diagnose and treat endometriosis prior to undergoing an egg retrieval or embryo transfer in hopes of improving your chance of a successful pregnancy.
“See a fertility doctor sooner rather than later when ready to start trying to conceive, as infertility is more common in women with endometriosis,” says Dr. Ryniec.
If you’re already considering IVF, laparoscopic surgery to remove scar tissue might be an option to consider before starting the egg retrieval process. According to Dr. Ryniec, “Surgery or medical suppression is likely beneficial for frozen embryo transfer by reducing inflammation related to endometriosis, improving live birth rates.” As for embryo transfer success specifically, “For most people with endometriosis, a frozen embryo transfer is the more successful route.”
Ultimately, knowledge is power when it comes to endometriosis and fertility. By being proactive, seeking answers for unexplained infertility, and understanding what using IVF with endometriosis may look like, you can navigate your journey with greater confidence and increase your chances of achieving a live birth. Best of luck!
Blair Sharp is a freelance writer who lives in Minnesota with her husband and son. Her words have been published in various publications, including Parents, SheKnows, The Bump, and Insider. She also writes the Hey Freelancer! newsletter. When she’s not writing, you can find her watching reality TV and sharing too many reels with her friends. To connect with Blair, find her on LinkedIn or head to her website www.blairsharp.com.