Endometriosis and Your Fertility

Overall, the chances of successfully conceiving with endometriosis are inversely proportional to the extent of the disease: The worse the endometriosis is, the harder it becomes to get pregnant. Fortunately, truly severe endometriosis is uncommon. Results obviously are very individual, but with proper management and treatment, the vast majority of women with endometriosis will successfully conceive.

If you have mild endometriosis and are going to have a laparoscopy in hopes of helping you conceive, your doctor may use that laparoscopy to do gamete intrafallopian transfer (GIFT). Pregnancy rates as high as 40 to 50 percent can be achieved after a single laparoscopy and a GIFT procedure. This percentage is far better than that which can be achieved following a laparoscopy and laser or cautery of endometriosis. And GIFT works just as well when endometriosis is present as it does when the endometriosis has previously been treated.

Of course there will be cases and circumstances where surgical intervention for endometriosis is clearly indicated. But the point is this: In the past, the possibility of finding a small amount of endometriosis and treating it has been the justification for many, many surgical procedures. Some women have actually had several laparoscopies, or even major surgeries, for this reason. Not only is this invasive, in that an individual must endure one or more surgical procedures, it is also expensive.

There are now far more effective ways of achieving pregnancy—ones that are more cost-effective and far less invasive. Some of these approaches will include ovulation induction and other assisted reproductive technology, or ART procedures.

John C. Jarrett II, M.D., is co-author of The Fertility Guide: A Couples Handbook for When You Want to Have a Baby (More Than Anything Else)