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Endometriosis and Fertility: Symptoms, Diagnosis and Getting Pregnant

Op. Dr. Ali İhsan Gönenç
Written & medically reviewed by: Op. Dr. Ali İhsan Gönenç
Published: 2026-07-13 · Updated: 2026-07-13
Woman learning about endometriosis and its effect on fertility

Endometriosis is a common condition in which tissue similar to the lining of the uterus grows outside the uterus. It can cause pain and, in some women, difficulty getting pregnant.

What is endometriosis?

In endometriosis, endometrial-like tissue settles on areas such as the ovaries, fallopian tubes or the lining of the pelvis. This tissue responds to hormonal changes each cycle, which can lead to inflammation, scarring and pain.

What are the symptoms of endometriosis?

  • Painful periods and pelvic pain
  • Pain during or after intercourse
  • Difficulty getting pregnant
  • Sometimes ovarian cysts (endometriomas, or "chocolate cysts")

Symptoms vary widely; some women have severe pain, while others have few symptoms and discover it during a fertility evaluation.

How is endometriosis diagnosed?

Diagnosis is based on your symptoms and examination, supported by ultrasound. Ovarian endometriomas are often visible on ultrasound, but superficial deposits may not be. Your doctor considers the overall picture when making the diagnosis.

Does endometriosis cause infertility?

Endometriosis can affect fertility by influencing egg quality, the pelvic environment and the fallopian tubes. However, it does not mean pregnancy is impossible — many women with endometriosis conceive, with or without treatment.

Can you get pregnant with endometriosis?

Yes. Depending on the severity and your individual situation, options range from timed natural conception to treatments such as IVF. Because IVF bypasses some of the ways endometriosis affects fertility, it is often an effective approach.

How is endometriosis managed for fertility?

Management is individualized based on the stage of the disease, your age and your goals. The focus is on relieving symptoms where needed and choosing the fertility approach most likely to help you conceive.

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FAQ

Frequently Asked Questions

Clear answers to the most common questions.

Endometriosis is a condition in which tissue similar to the uterine lining grows outside the uterus, such as on the ovaries or pelvis. It can cause pain and fertility difficulties.

The exact cause is not fully known, but hormonal and genetic factors are thought to play a role. The misplaced tissue responds to hormonal changes each cycle.

Common symptoms include painful periods, pelvic pain, pain during intercourse and difficulty conceiving. Some women also develop ovarian endometriomas.

Diagnosis is based on symptoms, examination and ultrasound. Ovarian endometriomas are often visible, but superficial deposits may not always appear on imaging.

Endometriosis can affect fertility through egg quality, the pelvic environment and the tubes, but it does not mean pregnancy is impossible. Many women conceive with or without treatment.

Yes. Depending on severity, options range from natural conception to treatments such as IVF. IVF is often effective because it bypasses some effects of endometriosis.

A chocolate cyst (endometrioma) is an ovarian cyst caused by endometriosis, containing dark, old blood. It is a common finding in endometriosis.

Endometriosis can influence egg quality and the pelvic environment, but many women still succeed with IVF. The approach is tailored to the stage of disease.

There can be a familial tendency, so having a close relative with endometriosis may increase the likelihood. However, many cases occur without a clear family history.

If you have persistent pelvic pain, painful periods or difficulty conceiving, an evaluation is recommended. Early assessment helps guide the right plan.