Fertility and IVF Treatment in Women with Endometriosis

Endometriosis is a chronic condition in which the womb lining deposits outside the womb. It can be debilitating and may affect your chances of getting pregnant. It is a relatively common condition and affects one in ten women world-wide. Almost one third to half of women suffering from infertility may have endometriosis.

What causes endometriosis?

There are many proposed causes of endometriosis, but the actual cause is still unknown. Some think that backflow of menstrual blood into the fallopian tubes may cause endometriosis.

In others, it may be inherited through some faulty genes running in families. This is particularly likely in women with moderate or severe endometriosis. Currently, a number of genes are being studied, but there are no clear frontrunners.

Besides these, it is thought in some patients, the endometrial cells may spread through the blood circulation system and deposit in other parts of the body, such as lungs and diaphragm.

Lastly, it may also result from exposure to environmental toxins such as dioxins. Dioxins may cause defective clearance of womb lining cells from other parts of the body.

What are signs and symptoms of endometriosis?

Endometriosis can affect your health in a number of ways. The signs and symptoms may vary from one to another. Some of these could be chronic pain, painful heavy periods, pain during sexual intercourse or ovulation pain, pain during defaecation or bowel movements. In rare cases, patients may suffer from cyclical pain during breathing or coughing if the endometriosis spreads to lungs or chest cavity, or cause fatigue. Some may face infertility or difficulties in getting pregnant.

How can you diagnose endometriosis?

The diagnosis of endometriosis is suspected based on your symptoms. Your gynaecologist or fertility specialist will do a thorough assessment. This may involve gynaecological examination, pelvic ultrasound scan or MRI of pelvis. However, it can only be confirmed through key-hole surgery called diagnostic laparoscopy.

What are the different stages of endometriosis?

Once a proper assessment has been completed then your gynaecologist or fertility specialist may be able to stage the severity of endometriosis whether it is mild, moderate or severe. These may or may not correlate with your symptoms. But it does give an idea about fertility especially for fertility treatment success.

How endometriosis affects your chances of getting pregnant? 

Endometriosis could affect fertility and chances of getting pregnant depending on various factors. Majority of women suffering from endometriosis are able to get pregnant naturally. This is especially the case if you have minimal or mild endometriosis.  If you have moderate to severe endometriosis, then you are more likely to experience infertility and may need fertility treatment.

Endometriosis may affect fertility in few different ways. The cyclical growth of endometriosis deposits releases toxins that make the body environment more hostile for pregnancy. This may result in infertility, miscarriage or failed IVF treatment. In others, it may result in scar tissue within these endometriosis deposits. This may result in blockage of one or both fallopian tubes. A blocked fallopian tube may prevent fertilisation of the released egg. In some patients, it may result in an abnormal immune response. This may affect implantation of the embryo in IVF treatment.

Depending on the stage of disease and the treatment that you have received, it is possible that your fertility may be affected. However, most women with endometriosis are able to get pregnant naturally. Though women with endometriosis are more likely to need some form of fertility treatment when compared to those who do not have endometriosis.  Almost one in two women with moderate to severe endometriosis may need infertility treatment, such as IVF .

Getting pregnant naturally with endometriosis?

The majority of women with endometriosis will conceive naturally. Most with mild or minimal endometriosis should try to conceive naturally. When trying to conceive naturally, you should take prenatal vitamin such as folic acid. You should make sure that you have a healthy and balanced diet, regular exercise and adequate sleep. You can track ovulation using apps or use ovulation predictor kits.

If you wish to know more about your fertility before trying or if you are thinking of delaying getting pregnant, then you can take fertility tests or MOT. These tests will provide information about ovarian reserve and whether there are any blockages in fallopian tubes.

If you fail to get pregnant or have irregular periods, then you should seek help from your GP or fertility specialist or a fertility clinic near you.

Does endometriosis treatment boost fertility?

If you have minimal or mild disease, then you may benefit from surgical treatment to improve chances of getting pregnant naturally or for IVF success. If you have moderate or severe endometriosis, then surgery to remove is unlikely to improve your chances. You should seek advice from a fertility specialist before considering surgery.

What are fertility and IVF treatment options for women with Endometriosis?

There are a range of fertility and/or IVF treatments available if you fail to conceive naturally. The choice of infertility treatment depends on the severity of endometriosis, age, duration for which you have been trying and any past failed IVF treatments. Depending on your circumstances as a couple, your fertility specialist may discuss best treatment options.

Endometriosis and IVF OR IVF / ICSI

IVF or In Vitro Fertilisation (IVF) with or without Intracytoplasmic sperm insemination (ICSI or IVF/ ICSI) is a common and an effective treatment. IVF involves taking fertility medications or injections for few weeks. Once you are ready, the eggs will be harvested. This is a minor operation and will be done under sedation.

What is the IVF success rate with endometriosis?

The IVF success rate with endometriosis depends on many factors including the severity or stage of endometriosis and your age. The chances of getting pregnant with minimal or mild endometriosis is no different from women without endometriosis. This may not be the case if you have moderate or severe endometriosis. The IVF success rates in women with moderate or severe endometriosis are usually lower when compared to women with mild or minimal disease or those without endometriosis.

Can endometriosis cause IVF failure?

The IVF success rates in women with endometriosis is influenced by a number of causes. These could be your age when having treatment, having severe endometriosis, whether endometriosis or its treatment has resulted in low ovarian reserve or poor egg or embryo quality. It may also cause immune mediated implantation dysfunction that may affect embryo implantation and result in failed IVF treatment.

Endometriosis and Ovulation Induction

Some women with endometriosis may have irregular ovulation or periods. This may happen if you suffer conditions such as PCOS or Polycystic Ovarian Syndrome. If you have endometriosis and have irregular periods, then simple treatments such as ovulation induction may restore your chances of conceiving naturally. You can speak to a fertility specialist to know more about ways to get pregnant without having to go through IVF.

Does endometriosis cause miscarriage?

When considering endometriosis and miscarriage risk, it is reassuring that the miscarriage risk is not significantly higher when compared to women with mild or minimal endometriosis or those without endometriosis. Endometriosis may cause delay in conceiving. But once you are pregnant, then the course of your pregnancy should be no different to women without endometriosis. Being pregnant may temporarily suppress flaring up of endometriosis and free you from some of the troublesome symptoms of endometriosis during pregnant.

How can I find a fertility clinic near me for endometriosis fertility treatment?

Your first step on the road towards fertility treatment involves speaking to your GP to know more about what is available to you on NHS. If you are looking for private fertility clinic, then you can self-refer to a fertility specialist who is experienced in looking after women with endometriosis. You can enquire about their experience in managing women with endometriosis, range of infertility treatments available at the clinic and costs of fertility tests and treatments.

Book appointment or open evening

At London IVF and Genetics Centre, we offer a wide range of detailed tests and fertility treatments at our fertility and IVF clinics in London and Milton Keynes.

You can call our nearest clinic (Wimpole Street, London: 02075800207; Milton Keynes: 01908915151) or  email enquiry@londonivfandgenetics.co.uk for more information or book your appointment.

You can also join our next open evening in London or Milton Keynes to know more about your options and ways in which we can help.

Related topics

You may also find the following articles of interest:

Polycystic Ovarian Syndrome – PCOS

Fertility Tests/MOT

Frequently Asked Questions

IVF Patient Journey