Can Endometriosis and PCOS Impact Fertility?

About 10-15% of women have endometriosis, and about 5-20% of women experience PCOS, polycystic ovary syndrome.

If you’ve been diagnosed with PCOS or endometriosis and you’re looking to finally start a family of your own, you might be left with various questions. How will these conditions impact your chances of conceiving? Do they interfere with ovulation? What should you be aware of?

Here’s everything you need to know about how PCOS and endometriosis can impact your fertility, as well as the key differences between these two conditions.


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Endometriosis vs PCOS 

While rare, a woman can have both of these two conditions at the same time. Similarly, both endometriosis and PCOS cause menstrual and hormonal issues. They both may further interfere with your ability to conceive. Yet, they are also very different. Below, we take a look at the key differences between these two conditions.


Understanding Endometriosis

Endometriosis is when the cells of the tissue that line your uterus grow in other parts of the body, such as the ovaries, rectum, pelvic area, and bladder. This condition is associated with higher estrogen levels. A woman with endometriosis might experience heavy bleeding, painful periods, bleeding between periods, pelvis pain prior to menstruation, pain during sex, painful urination or bowel movements, and low energy.

Additionally, endometriosis can impact your fertility. If this tissue grows in your fallopian tubes, ovaries, or other reproductive areas, you may struggle to get pregnant. What’s happening here? This tissue becomes thick throughout your menstrual cycle. It also bleeds, similar to the tissue in your uterus. This is the main cause of inflammation, pain, and discomfort associated with endometriosis. It is also one of the main reasons why you might have difficulty conceiving. This inflammation and tissue growth can interfere with your natural anatomical set-up, leave scarring in your fallopian tubes, impair egg implantation, and more.

However, there is good news! About 70% of women with endometriosis get pregnant – without any treatment required (more on this in a bit).

Understanding PCOS

Polycystic ovary syndrome (PCOS) is a hormonal disorder characterized by small and large cysts that grow on the outside of the ovaries. Yet, a woman can have PCOS without having cysts. In these cases, you may experience no periods or irregular periods, which leads to brown discharge associated with PCOS, and you may experience higher levels of the androgen hormones. You may also experience all of the above.

Interestingly, some experts refer to PCOS as a metabolic disorder. This is because PCOS is associated with insulin resistance, which is intricately linked with metabolic function. Insulin is required for your cells to take in glucose. If you become insulin resistant, your cells cannot take in glucose and make energy from it. This results in blood sugar dysregulation and other problems.

PCOS is further one of the main causes of infertility in women (yet, it is treatable!). The hormonal imbalances, particularly the increase in testosterone, associated with PCOS may disrupt ovulation. This often means that the eggs in the ovaries have not developed properly and thus, have not been released. On the other hand, if ovulation does occur during PCOS, these hormonal imbalances may also impact the ability of the egg to implant within the uterus.

About 30-50% of women with endometriosis will face problems getting pregnant. Yet, there are various fertility treatments available, which can help you achieve the family you’ve always dreamed of.

Tracking Ovulation With PCOS or Endometriosis

There are many ways to track your cycle and determine if you are, in fact, ovulating. This can help you assess your condition and fertility before seeking out other options. Again, it is possible to get pregnant with PCOS and endometriosis. But first, it’s essential to determine if ovulation is happening in the first place.

On average, a woman ovulates about 14 days before her next period. Before you ovulate, you may notice that your vaginal secretion changes. This secretion is often clear and stretchy. You can also take your basal body temperature to determine when and if ovulation is happening. During ovulation, your body temperature will rise slightly. To notice this change, you must be tracking your temperature on a regular daily basis.

Lastly, there are various ovulation tests and kits you can use to determine if ovulation is occurring or not. At the same time, it’s important to note that each woman’s cycle is different. Tracking your cycle for many months can help you determine your cycle length and its phases.

What if Ovulation Isn’t Happening?

For both PCOS and endometriosis, your doctor may recommend making certain lifestyle changes to improve your chances of conceiving. These may involve diet changes, such as including more nutrient-rich food sources, and other weight management strategies.

For PCOS, if ovulation isn’t happening, medication may be required to trigger ovulation. However, treatment will depend on the severity of your condition, your age, and your symptoms. For instance, in severe cases of endometriosis, your doctor may recommend surgery to remove tissue growth disrupting natural reproduction.

If you have endometriosis or PCOS and you wish to get pregnant, know that it is possible. There is hope. Understanding your condition and how it impacts your fertility and your body is a great starting point toward achieving this goal.