Endometriosis can make conceiving more difficult, but it does not mean you cannot get pregnant. Many people with endometriosis conceive naturally, and many others conceive with support.

Endometriosis is a common gynaecological condition in which tissue similar to the uterine lining grows outside the uterus. It can cause pain, inflammation and scarring in the pelvic organs.

Because the condition affects the reproductive system, many people wonder how it might affect fertility. Here's what studies and medical guidelines currently show.

How common is endometriosis?

Endometriosis affects around 10% of people of reproductive age worldwide — approximately 190 million people — making it one of the most common gynaecological conditions.

It is more common among people experiencing infertility. Studies estimate that endometriosis is present in a substantial proportion of people investigated for infertility, with figures often cited around 25–50%.

That figure is worth reading carefully. It describes how often endometriosis turns up among people already experiencing infertility. It does not mean that a quarter to a half of everyone with endometriosis will be infertile. Many people with endometriosis conceive without difficulty.

Does endometriosis cause infertility?

Endometriosis does not always affect fertility, but it can interfere with several of the steps involved in conception.

Research suggests the condition may affect fertility by:

• causing inflammation in the pelvic organs

• creating scar tissue or adhesions around the ovaries or fallopian tubes

• affecting ovulation or aspects of egg quality

• affecting implantation

These mechanisms can reduce the likelihood of conception in some individuals. Studies suggest the monthly chance of pregnancy may be lower in people with endometriosis — often cited at around 2–10% — compared with those without, although estimates vary depending on the population studied.

Can you still get pregnant with endometriosis?

Yes. Many people with endometriosis conceive naturally, although the likelihood varies widely depending on individual factors.

The impact on fertility often depends on:

• the stage or severity of endometriosis

• whether scar tissue affects the fallopian tubes or ovaries

• age and ovarian reserve

• the presence of other fertility conditions

Because of this variability, outcomes differ significantly between individuals, and general statistics may say very little about any particular person's situation. Endometriosis can also occur alongside other conditions that affect fertility — PCOS and Miscarriage: Is There a Connection? covers another of the most common.

Does endometriosis increase miscarriage risk?

Some research suggests endometriosis may be associated with a higher risk of miscarriage, but the findings are not consistent.

Some studies have reported miscarriage rates of around 20% in people with endometriosis, compared with around 12% in people without. Other research has found rates similar to those seen in other infertility groups or among IVF patients, which suggests that some of the difference may relate to fertility treatment and underlying fertility factors rather than endometriosis itself.

Researchers believe inflammation, hormonal factors, or changes in how the uterus functions in early pregnancy may contribute, though more research is needed.

What this means in practice is that the evidence is genuinely mixed. Endometriosis may carry some additional risk, and the size of that risk is not settled. For the wider picture of what does and doesn't cause miscarriage, read What Causes Miscarriage? Common Myths vs. Medical Facts.

What fertility treatments can help?

If endometriosis is affecting fertility, several approaches may be considered:

• surgical removal of endometriosis lesions or scar tissue

• ovulation-induction medications

• in vitro fertilisation (IVF)

The right approach depends on individual factors such as age, symptom severity, and how long you have been trying to conceive. A fertility specialist can advise on what is likely to help in your situation. If you have experienced a loss during fertility treatment, Coping With a Miscarriage During IVF or IUI covers the particular grief that comes with that.

If you've had a loss with endometriosis

Reading that a condition you already live with is associated with higher miscarriage risk can be hard, particularly if you have already had a loss.

It is worth holding onto two things. The evidence on this is mixed rather than settled. And an association measured across large groups of people cannot tell you the cause of any individual loss — most miscarriages happen because of random chromosomal changes in the embryo, whether or not endometriosis is present.

Many people with endometriosis spend years having their pain minimised or misattributed before receiving a diagnosis. If a loss has arrived on top of that history, it can be difficult not to read it as further evidence that your body is at fault. The research does not support that reading.

If you would like to know what investigating a loss actually involves and when it is offered, How Do Doctors Test for the Cause of a Miscarriage sets it out. When Should You Get a Check-Up After a Miscarriage covers what to expect from follow-up care, and is a good place to raise questions about endometriosis and future pregnancies.

Key takeaways

• Endometriosis affects about 1 in 10 people of reproductive age.

• It is found in around 25–50% of people investigated for infertility — though many people with endometriosis conceive without difficulty.

• The condition may affect fertility through inflammation, scarring, or effects on ovulation and implantation.

• Some research suggests a higher miscarriage risk, but findings vary and the evidence is not settled.

• Fertility treatments such as surgery or IVF may help in some cases.