If you have endometriosis, you know that the condition can be stressful all on its own. But once you start thinking about getting pregnant, it’s completely normal to wonder how endometriosis might affect your ability to conceive—not to mention whether you or your baby will be at risk once you do get pregnant.
Having the facts just might help ease some of your concerns. Here’s everything you need to know about conceiving with endometriosis, plus how the condition could affect your pregnancy.
What is endometriosis?
Endometriosis is a condition where tissue similar to the lining of the uterus grows in places where it shouldn’t—like the ovaries or fallopian tubes, on the outside of the uterus, or, rarely, in other parts of the body.
Endometriosis growths aren’t dangerous. But they’re often painful, and they can affect a woman’s ability to get pregnant.
Who’s at risk for endometriosis?
Endometriosis can affect any girl or woman of menstruating age, but it most often strikes women in their 30s and 40s. It is estimated that around 11% of U.S. women aged 15-44 have endometriosis.
But age isn’t only factor that could make endometriosis more likely. You might also be at higher risk if:
- You’ve never had children.
- Endometriosis affects your mother, sister(s), or aunt(s).
- Your periods last longer than 7 days.
- Your menstrual cycle is shorter than 27 days.
- You have a health problem that blocks normal blood flow during your period.
How do you know if you have endometriosis?
Pain is the most common symptom of endometriosis. You might have super intense period cramps, chronic aching in your lower back or pelvis, a deep-feeling pain during or after sex, intestinal discomfort or painful bowel movements. Bleeding or spotting between periods as well as digestive problems (like diarrhea, constipation, bloating or nausea, especially during your period) are also common.
Endometriosis can also affect fertility. Not every woman with endometriosis experiences pain as a symptom, and for some, trouble getting pregnant is the first clue that they might have the condition.
If you think you might have endometriosis, start by talking with your doctor. She’ll conduct a preconception checkup or a pelvic exam to screen for the condition. If she suspects endometriosis is a possibility, she’ll recommend a minimally invasive surgical procedure called a laparoscopy to get a better look at your pelvis and confirm the diagnosis.
What causes endometriosis?
The cause of endometriosis is still unknown. But many experts think that endometriosis is caused by problems related to period flow—like blood flowing backwards through the fallopian tubes and into the pelvis. Genetic factors, immune system problems and hormones might also play a role.
How does endometriosis affect your ability to get pregnant?
Experts are still trying to understand the relationship between endometriosis and fertility. But they suspect that patches of endometriosis tissue might get in the way of sperm trying to find the egg. The condition could make it harder for an embryo to implant on the wall of the uterus, too. Endometriosis might also cause a woman’s immune system to attack an embryo instead of trying to protect it.
Can you still conceive if you have endometriosis?
Women with endometriosis can still conceive, but it might take longer or be more difficult. Almost 40% of women who struggle with infertility have endometriosis, according to the American College of Obstetricians and Gynecologists. The severity of the condition does not appear to have a relationship to infertility—that is, women with more severe endometriosis symptoms don’t necessarily have a harder time conceiving compared to women with less severe symptoms.
Experts generally recommend trying for a year to get pregnant before seeking help. But if you have endometriosis, you might want to talk with your doctor sooner—around six months after you begin trying to conceive.
What are the treatments for endometriosis?
There’s no cure for endometriosis, but there are ways to treat the symptoms and improve your chances of conceiving.
If you’re trying to get pregnant, your doctor might recommend taking medication like a gonadotropin-releasing hormone antagonist. It temporarily stops your body from making hormones that trigger ovulation and spur the growth of endometriosis patches. Stopping the patches from growing could make it easier to conceive after you stop taking the medication. Your doctor might also recommend surgery to remove existing growths.
These treatments are thought to improve a woman’s chances of getting pregnant, but it’s hard to say by how much. If medication or surgery isn’t effective in helping you and your partner conceive, your doctor might recommend in vitro fertilization or intrauterine insemination, or IUI. Both of these treatments can help bypass the problems that make it harder to get pregnant with endometriosis—like the sperm reaching the egg or the embryo having trouble attaching to the wall of the uterus.
What are the possible risks of endometriosis to the mother and baby?
Endometriosis can have an effect on conception, but it doesn’t necessarily mean you’ll have a high-risk pregnancy.
That said, having the condition could increase the risk for certain problems. Research shows that women with endometriosis are anywhere from 1.6 to 15 times more likely to have placenta previa, where the placenta implants low in the uterus and covers all of part of the cervix. That could make you more likely to need a C-section.
Other findings suggest that having endometriosis could increase the risk for miscarriage, preterm birth, or preeclampsia, though experts aren’t sure by how much. In very rare cases, the condition could also cause serious or even life-threatening internal bleeding.
All of this might sound scary. But keep in mind that many women with endometriosis have perfectly normal pregnancies and deliveries. Still, it’s completely understandable to worry—so share your concerns with your doctor. She’ll help you better understand your risk for complications and come up with the best care plan for you and your baby.
How can you get pregnant if you have endometriosis—and will you always need help conceiving?
Some women with endometriosis have no problem conceiving, while others need help. It’s hard to know which group you’ll fall into ahead of time, so you and your partner should start off trying to get pregnant naturally.
When should you talk to your doctor if you’re running into trouble? In general, couples where the woman is under 35 should seek help after trying to get pregnant for a year, while couples where the woman is over 35 should seek help after six months. But some experts say women with endometriosis should seek help at the six-month mark no matter how old they are. Talk with your partner and your doctor to decide what timeframe feels right for you.
If you’re having trouble conceiving, your doctor might start by recommending surgery to remove endometrial growths, which can make it harder for sperm to find the egg. If surgery isn’t enough, the next steps are either in vitro fertilization or intrauterine insemination, or IUI. But unfortunately, there aren’t any hard numbers for how successful these procedures are for women with endometriosis.
As for having a second child, your experience getting pregnant the first time won’t necessarily predict how things will go in the future. Pregnancy suppresses many of the inflammatory processes that are related to endometriosis, so it’s possible that getting pregnant a second time might even be easier. Still, that’s not always the case. If you conceived after undergoing surgery to remove endometrial growths, it’s possible to develop new growths that cause problems next time around.
Does endometriosis affect your ability to carry a baby to term?
Some findings suggest that endometriosis is tied to a higher risk for miscarriage as well as bleeding problems. But according to the evidence, endometriosis-related complications are rare, and most experts agree that the condition doesn’t have a harmful effect on most pregnancies.