Experts estimate that about half of women with infertility also have endometriosis. In a woman with endometriosis, swollen tissue can block the fallopian tubes or grow into the ovaries, making it more difficult—though not impossible—for a woman to get pregnant.
Endometriosis can also affect fertility by:
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- Preventing an embryo from implanting
- Scarring the fallopian tubes
- Affecting egg growth
- Creating a hormonal imbalance
- Causing chronic inflammation in the pelvis
Endometriosis fertility index
If a woman with endometriosis wants to conceive, a doctor may evaluate how likely she is to get pregnant without medical intervention, based on a 10-point endometriosis fertility index (EFI) score.
Factors include:
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- Age
- Endometriosis stage
- Fallopian tube and ovarian functioning
- Length of infertility
- Medical history
- Prior pregnancies
According to a 2021 study, women with scores of 5 or higher can try conceiving naturally for 24 months before medical intervention. Those with scores of 4 or lower should be referred more quickly for artificial reproductive treatments.
Treatment
Endometriosis is a painful, challenging condition that can be difficult to cope with, both physically and emotionally. Women with endometriosis struggling to get pregnant may feel isolated and discouraged, especially if they have been trying for a number of years without success.
There is no cure for the disorder, but there are mental health treatment options and lifestyle changes that can ease symptoms, help with pain management and improve quality of life.
Treatments include:
Dietary help: Women can avoid food that causes inflammation and other hormonal activity. Research confirms a link between endometriosis and diets low in fruits and vegetables, high in red meat or heavily laden with trans fats. Women whose diets were rich in omega-3 oils lowered risk of endometriosis by 22%. Deficiency in vitamin D may also play a role.
Exercise plan: 75% of woman engaging in high-intensity exercise are less likely to develop endometriosis, and it can help reduce symptoms in women who do develop the illness.
High-intensity exercise can help by:
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- Encouraging blood circulation
- Maintaining nutrients and oxygen flow
- Decreasing estrogen production
- Reducing stress
- Releasing pain-relieving endorphins in the brain
Low-intensity exercise, including yoga, can stretch and strengthen muscles and reduce pelvic pain and stress.
Relaxation techniques to manage stress: Not only can stress be exacerbated by endometriosis—due to the impact of painful symptoms on all aspects of life, including family, personal relationships and work—but endometriosis symptoms can be exacerbated by stress: a never-ending cycle. Relaxation techniques—from deep breathing and visualization to progressive muscle relaxation—help women to refocus on something calming and reduce stress hormone activity.
Medications: Doctors can provide the best medication option, depending on age, symptoms, desire to become pregnant and prior treatments.
Hormone therapy: This can help slow down endometrial tissue growth, prevent new growth of endometrial tissue and reduce or eliminate endometriosis-related pain.
