I Have Endometriosis: Can I Still Get Pregnant?

I Have Endometriosis: Can I Still Get Pregnant?

Around the world, approximately 89 million women and girls suffer from a condition called endometriosis. The normal endometrium is a blood-filled tissue that lines your uterus and thickens in preparation for a baby each month.

If your egg isn’t fertilized, the endometrium sheds from your uterine walls through your vagina, a state known as menstruation. However, if you have endometriosis, the endometrium grows in areas outside of the inner uterus, too. In fact the endometrium can grow on the:

When the abnormal endometrium tries to shed, after you don’t get pregnant, it has nowhere to go. This can cause cramping and pain. In addition, the abnormal tissue can become inflamed and cause adhesions, a scar-like tissue that “glues” tissues together and can also cause pain and dysfunction.

If you have endometriosis, your OB/GYN may put you on hormonal birth control to alleviate the heavy bleeding and pain associated with the condition. When it’s time to get pregnant, you must stop all birth control, of course. But can you still get pregnant, despite the endometriosis?

At Mian OB/GYN & Associates, our expert OB/GYN, Dr. Rafiq Mian, treats endometriosis and other reproductive issues at our office in Silver Spring, Maryland. If you have endometriosis, you may need extra support if you want to get pregnant.

What should you know about conception and pregnancy if you have endometriosis? The following is a brief guide.

What stage of endometriosis do you have?

Even if you know you have endometriosis, you may not be aware of the stage of your condition. Up to half of women with endometriosis have trouble conceiving. But that means the other half won’t have difficulty. Which half describes you best?

During treatment or diagnosis, Dr. Mian can stage your endometriosis. The stage then determines how much intervention you may need to successfully conceive. 

Stage 1

Endometrial tissue is minimal and scant. No scar tissue or adhesions are present. In Stage 1, you can usually get pregnant on your own once you stop birth control. 

Stage 2

Mild endometriosis, in which fewer than two inches of the abdominal cavity are affected. You don’t have adhesions or scars. It’s possible to get pregnant on your own. 

About 80% of couples get pregnant within six months of having regular intercourse without protection or birth control. Another 5% achieve pregnancy by 12 months, assuming the female is less than 35-37 years old. 

If it takes longer than a year, you’re considered infertile. If you’re over 35 and a female, don’t wait for more than six months before exploring assisted reproductive technologies (ART).

Stage 3

Moderate, stage 3 endometriosis may create fluid-filled pockets in your ovaries. Your ovaries and your fallopian tubes also may be scarred. You’re likely to need ART to get pregnant. 

Stage 4

If you have stage 4 endometriosis, your condition is so severe that it may scar and damage your ovaries. It can also create large ovarian cysts, block your fallopian tubes, and distort other areas of your reproductive and pelvic anatomy. These changes make ART a necessity in most cases.

Restore your fertility 

If your endometriosis compromises your fertility, Dr. Mian customizes a treatment based on your stage, your age, and other factors:

If you’re under 37 with stage 1 or 2 endometriosis

If you’re under age 37 and have stage 1 or 2 along with good ovarian reserve, we may simply remove abnormal tissue. Then we wait and see if pregnancy occurs without further intervention. 

If it doesn’t, we may advise fertility drugs and intrauterine insemination (IUI) for 3-6 cycles. If you still don’t get pregnant, then we refer you for in vitro fertilization (IVF). 

If you have stage 3 or 4 endometriosis

If you’re under 37 with stage 3 or 4, you could either go straight to IVF or give IUI a try beforehand. If you’re over age 37 or have poor ovarian reserve, we recommend immediate IVF.


Don’t give up on your dreams of having a baby simply because you have endometriosis. Call our friendly team or use our online form to set up a consultation today.

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