Endometriosis can affect fertility in different ways, but understanding the condition and knowing what support is available can help you feel more informed and reassured.
Written by Endometriosis UK.
If you have endometriosis, or you are going through the diagnosis process, you may be feeling concerned about your fertility. It’s important to remember that endometriosis does not necessarily cause infertility but there is an association with fertility problems, although the cause is not fully established. Even with severe endometriosis, natural conception is still possible. It is estimated that 60-70% of those with endometriosis can get pregnant spontaneously.
Due to a lack of research, the links between fertility and endometriosis are not fully known. In some cases, it may be because the disease distorts the reproductive organs.
The main factor affecting fertility for anyone is their age. You are born with a lifetime supply of eggs that undergo maturation monthly once you have reached puberty. Fertility rapidly declines after the age of 38 both due to the rate at which the egg sacs disappear from the ovaries accelerating and due to increased rates for miscarriage and chromosomal abnormalities.
For those with endometriosis who do experience fertility issues, a proportion will get pregnant after medical assistance, either surgery to remove endometriosis or through assisted reproduction technologies (i.e. IVF).
For many with a diagnosis of endometriosis, fertility and fertility preservation is a significant concern. For some, a diagnosis of endometriosis comes as a result of investigations following fertility issues. For others, the lack of a timely diagnosis of endometriosis means they can lose the opportunity to consider the potential impact on fertility and to take steps towards fertility preservation.
Endometriosis UK believes that anyone whose fertility is affected by endometriosis should be able to access fertility support. Despite the known links between endometriosis and infertility, under current Guidelines, those with endometriosis cannot always access fertility preservation including egg freezing procedures.
In some cases, endometriosis can result in painful sex. Endometriosis latest diagnosis research, released in March 2026, highlights that painful sex is a symptom of endometriosis that is often minimised by healthcare practitioners, despite its potential impact on relationships and, should someone want to conceive, pregnancy outcomes.
In our survey, we specifically asked about experience of fertility treatments. It found that 58% of respondents were asked by a medical practitioner if fertility was important to them; 34% of respondents who have had fertility treatment were diagnosed before it started, and 32.5% were diagnosed whilst being investigated for fertility issues.
If you are concerned about your fertility or experiencing symptoms of endometriosis, please speak to your GP or a healthcare practitioner.
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