Endometriosis and Its Impact on Fertility and Pregnancy

Did you know that nearly 25-50% of infertile women have endometriosis?¹ This guide covers what endometriosis is, how it’s diagnosed, treatment options, and its impact on fertility and pregnancy.

What is Endometriosis? A Common but Often Misunderstood Condition

Endometriosis is a chronic condition where tissue similar to the uterine lining grows outside the uterus, often on the ovaries, fallopian tubes, and other pelvic structures. This misplaced tissue behaves like the uterine lining—it thickens, breaks down, and bleeds with each menstrual cycle. However, unlike normal menstrual tissue, it has no way to exit the body, leading to inflammation, scarring, and sometimes the formation of painful cysts called endometriomas.

Endometriosis affects an estimated 10% of women of reproductive age², and its genetic component means that women with a first-degree relative with endometriosis are up to 3 to 7 times more likely to develop it³. Despite its prevalence, the condition is often underdiagnosed, with an average delay of nearly 8 years between symptom onset and diagnosis.⁴

Symptoms of Endometriosis - More than just painful periods

Many women with endometriosis experience severe symptoms, while others may have mild or no symptoms at all. Common signs include:

Painful periods, including pelvic pain and cramping
Painful intercourse
Heavy or irregular periods
Bleeding in between periods
Deep pain during ovulation, bowel movements or urination, especially during menstruation
Bloating, diarrhea, or constipation
Infertility, affecting up to 50% of women with endometriosis

Since these symptoms overlap with other conditions like irritable bowel syndrome (IBS) or pelvic inflammatory disease (PID), misdiagnosis is common.

How Does Endometriosis Affect Fertility and Conception?

Endometriosis is one of the leading causes of infertility, with studies indicating that 25–50% of infertile women have the condition¹. Several mechanisms contribute to fertility challenges:

Inflammation and scarring: Chronic inflammation can interfere with egg quality, implantation, and embryo development.
Blocked fallopian tubes: Adhesions from scar tissue can prevent sperm from reaching the egg.
Hormonal imbalances: Endometriosis may disrupt ovulation and progesterone production, making conception more difficult.
Altered immune response: The immune system may mistakenly attack sperm or embryos, reducing the chances of pregnancy.

While endometriosis can complicate conception, many women with the condition successfully become pregnant with supplements, lifestyle adjustments or medical intervention.

How is Endometriosis Diagnosed?

Despite its significant impact on fertility and quality of life, endometriosis remains difficult to diagnose. Many women see multiple doctors over several years before receiving a confirmed diagnosis.

Traditional diagnosis requires laparoscopy, a minimally invasive surgery where a small camera is inserted into the abdomen to detect abnormal tissue growth. However, non-invasive methods such as pelvic ultrasounds and MRI scans can help identify ovarian endometriomas and deep infiltrating endometriosis, improving early detection rates.

What are the treatments for endometriosis?

There is no cure for endometriosis, but various treatments can help manage symptoms and improve fertility outcomes. Treatment plans should be tailored to individual goals—whether pain relief, improving fertility, or slowing disease progression.

1. Goal: Manage Symptoms

Omega-3: Research suggests that supplementation with Omega-3 (found in fish oil) may help reduce inflammation associated with endometriosis, with one study showing a 50% reduction in severity after increased intake.⁵

Anti-inflammatory diet: Incorporating antioxidants like Vitamins A, C, E, and Zinc can help reduce inflammation associated with endometriosis. ⁶

Magnesium and Vitamin B6: These nutrients have been shown to alleviate menstrual cramps and reduce pelvic pain.⁵

Hormonal treatments: Birth control pills, progestins, and GnRH agonists can suppress estrogen production, slowing endometrial tissue growth.⁷

Pain relief medications: Ibuprofen and other NSAIDs help reduce inflammation and pain, while nerve pain medications such as gabapentin may provide relief in severe cases.

2. Goal: Improve Fertility Outcomes

CoQ10 supplementation: Research has shown that CoQ10 may improve egg quality, particularly in women with endometriosis, by enhancing mitochondrial function in eggs.⁸

Myo-inositol: Clinical studies suggest that myo-inositol can help regulate ovulation and improve egg quality, particularly in women with hormonal imbalances due to endometriosis.⁹

Fertility medications: Ovulation-inducing drugs may be prescribed to stimulate egg production.

Laparoscopic excision surgery: In cases where scar tissue is significantly impacting fertility, surgical removal of adhesions can improve fertility outcomes.

IVF (In Vitro Fertilization): IVF remains a viable option for women struggling to conceive naturally.

How does endometriosis affect pregnancy?

The good news is that pregnancy often reduces endometriosis symptoms due to the hormonal shifts that suppress menstrual cycles. However, studies have shown that women with endometriosis may have a higher risk of:

Miscarriage, with research suggesting up to an 80% increased miscarriage risk with endometriosis.¹⁰
Preterm birth, with endometriosis patients 1.5x more likely to have preterm labor before 37 weeks, according to a study.¹¹
Preeclampsia (high blood pressure in pregnancy)
Cesarean delivery

Women with endometriosis who conceive through IVF (in vitro fertilization) should discuss their pregnancy risks with a healthcare provider, as assisted reproductive technologies (ART) may slightly increase complications.

Planning for Pregnancy with Endometriosis

If you have endometriosis and are trying to conceive, focusing on lifestyle changes and targeted supplements can support your fertility journey:

Take key fertility and prenatal supplements: CoQ10 supports egg quality, myo-inositol regulates ovulation, and folate / folic acid aids fetal development—key for those with endometriosis.
Limit caffeine and alcohol: Excess intake may disrupt hormones and fertility.
Exercise: Walking, yoga, and strength training help reduce inflammation.
Manage stress: Mindfulness or acupuncture support hormone balance.
Eat nutrient-rich diet: Anti-inflammatory nutrients like Omega-3s, vitamin D, and magnesium promote reproductive health whether through food or supplementation

Supporting Your Fertility with the Right Supplements

At BabyRx, we are committed to supporting women at every stage of their fertility journey. Our carefully formulated Fertility and Prenatal Supplements contain essential nutrients like CoQ10, folate, myo-inositol and Omega-3 fatty acids, which may support reproductive health and egg quality and help women with endometriosis.

Sources:

Senapati, Managing Endometriosis, https://www.pennmedicine.org/research-at-penn/online-research-interviews/managing-endometriosis-leading-to-infertility
Moradi et al., Prevalence of endometriosis in women, https://doi.org/10.4103/ijmr.ijmr_817_18
Kim et al., Familial risk for endometriosis, https://doi.org/10.1111/1471-0528.16769
Wrobel et al., Diagnostic delay of endometriosis, https://doi.org/10.1016/j.advms.2022.02.003
Bahat et al., Dietary supplements for endometriosis, https://doi.org/10.23750/abm.v93i1.11237
Liu et al., Dietary inflammatory index and endometriosis, https://doi.org/10.3389/fnut.2023.1077915
Vannuccini et al., Hormonal treatments for endometriosis, https://doi.org/10.1007/s11154-021-09666-w
Dymanowska-Dyjak et al., Oxidative Imbalance in Endometriosis, https://doi.org/10.3390/ijms25126298
Gambioli et al., Myo-Inositol, https://doi.org/10.3390/ph14060504
Minebois et al., Endometriosis and miscarriage, https://doi.org/10.1016/j.gofs.2017.06.003
Kim et al., Women with endometriosis have an increased risk of preterm birth, https://doi.org/10.5468/ogs.2017.60.3.283