Getting diagnosed with Endometriosis is difficult enough, often involving years (the average wait time is 8 years) of appointments or high private healthcare costs — so it can be pretty daunting, as well as confusing when you are told that Endometriosis can impact your fertility. But getting pregnant with Endometriosis is still possible! We at ScreenMe have explained a few of the key points surrounding Endometriosis and fertility, so that you can stay informed about your own health. 

Quick recap: what is Endometriosis?

To put it simply, Endometriosis is a condition where additional tissue (similar to that which lines your uterus), reacts to your menstrual cycle and bleeds each month. This extra blood cannot leave the body, resulting in inflammation, pain, and other symptoms. For more information, check out our previous blog on ‘What is Endometriosis and do I have it?’

Fertility issues 

Despite more and more women being diagnosed with Endometriosis (there are roughly 1.5 million women in the UK currently living with the condition), there is shockingly little research in to it. This makes any conclusions drawn inconclusive and so we cannot be entirely sure of the full implications of such on fertility. However, Endometriosis is associated with fertility issues, being thought to be due to changes to the reproductive system that it causes. 

That being said, it is still thought that most (60% – 70%) of women with Endometriosis are still able to get pregnant spontaneously, and even women with severe Endometriosis have been able to conceive. Therefore, this is something that you can definitely manage and work around, should you be worried about your fertility prospects. Having Endometriosis may just mean that you need to be a little more careful when trying to get pregnant, or may take slightly longer than expected.

Why is it more difficult for those with Endometriosis?

These are the main ways in which Endometriosis is thought to impact on your fertility. However, diet and lifestyle can significantly improve your fertility and negate these effects — so do not worry too much! 

• Increased inflammation 
  • Can decrease egg quality, due to higher-than-average levels of stress hormones (such as ROS — reactive oxygen species) circulating the body, which are associated with inflammation. These ROS can reduce your egg quality.
  • Can influence successful implantation by making it more difficult for an embryo to implant in the uterus lining. 
• Presence of endometrial tissue on or in the ovary
  • This is otherwise known as Endometrioma and research suggests that this is associated with your ovarian reserve, and suggests there is a faster rate of decline of AMH in comparison to those without. This may mean that those with Endometriosis should consider their fertility options earlier than others, but does not mean they will have difficulty conceiving. 
• Adhesions and Scarring of the Ovaries and Fallopian Tubes 
  • The bleeding of endometrial cells and. The resultant inflammation, causes scar tissue. The presence of this scar tissue makes it more difficult for released eggs to move down the fallopian tube to be fertilised, and then to move towards the uterus to be implanted. 
  • Adhesions on the ovaries reduce the blood flow to the ovaries, leading to a higher chance of cysts and damage. 
• Endometrial Polyps 
  • Women with Endometriosis are more likely to have small, non-cancerous growths of endometrial tissue in their uterus, which can make implantation more difficult. These are able to be removed through surgery, but may not be necessary. 

Tips for those with Endometriosis who are trying to conceive

1. FOODS TO GO FOR — diet is key not just to your fertility chances, but also for your general health and wellbeing. 

• Mediterranean diet
  • This is often seen as the best diet for those with Endometriosis, reducing inflammation and helping to keep hormones balanced

• Anti-oxidants 
  • Help to reduce inflammation, often helping to alleviate chronic pelvic pain
  • Found in dark leafy greens, dark chocolate, blueberries, beetroot

• Omega-3 fats
  • Help to reduce inflammation
  • Found in oily fish, nuts and seed

2. FOODS TO AVOID 

• Highly processed foods 
  • Increase inflammation and often increase symptoms associated with Endometriosis 
  • Fast foods are generally something to avoid if you are trying to stay healthy and improve your fertility chances

3. EXERCISE

• Light to moderate exercise is best for those with Endometriosis, and just in general for health 
• Walking, swimming, cycling are all brilliant ways to stay healthy and improve fertility chances.

4. LIFESTYLE

• Certain activities including smoking, drinking and high exposure to pollutants, can increase the levels of ROS in your body, contributing to inflammation and the negative impacts this has on fertility 
• Of course, this may not always be possible, so we recommend moderation. 

This should have cleared up a few of the common misconceptions and confusion surrounding Endometriosis and fertility. If you want to learn more, check out the rest of our blog! 

Jessica Hobbis