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How Endometriosis Impacts Fertility

Endometriosis is a very common reproductive disorder in women. In fact, 1 in 10 women are affected by endometriosis.

Many women connect endometriosis to painful periods, but did you know that endometriosis can also impact your fertility? Keep reading to learn more about endometriosis and how it can affect your in your fertility journey. 

What is endometriosis?

Endometriosis is a condition in which the endometrial tissue of the uterine lining develops outside of the uterus. This tissue can be found in abnormal locations such as the ovaries, fallopian tubes, and other parts of the abdominal cavity.

During your cycle, the uterine lining (or endometrial tissue) grows and thickens to prepare for the implantation of an embryo. If conception doesn’t occur and there’s no embryo to implant, the uterus sheds its lining and menstruation occurs. 

If a woman has endometriosis, the endometrial tissue will thicken each cycle - even if it is found outside of the uterus. When it’s time to shed the lining, the tissue outside the uterus will break down and start to bleed, just as we see inside the uterus. But, the broken down endometrial tissue and blood have no way of being expelled from the body, therefore causing inflammation and irritation of the other tissues it may be affecting.

What causes endometriosis?

Research is conflicting surrounding what exactly causes endometriosis; the truth is most experts aren’t really sure of the root cause. However, some research has shown that excess estrogen can promote endometriosis, meaning women with endometriosis often have higher estrogen levels compared to progesterone. Other potential causes include problems with menstrual flow, genetic factors, and immune system problems. 

How is endometriosis diagnosed and treated?

Awareness of common signs and symptoms of endometriosis can help you understand if you may be at risk. The primary symptom associated with endometriosis is pelvic pain, particularly around the time of your period. While many women experience menstrual pain, women with endometriosis say their pain is much more severe. Pelvic pain can start several days before your period and continue throughout it. 

Other women also notice abdominal and lower back pain. Some women may experience pain during intercourse, bowel movements, or urination, most commonly during their period. 

If you have extremely painful periods, we recommend consulting your doctor. Sometimes, but rarely, endometriosis can be diagnosed through pelvic or abdominal exams. More commonly, endometriosis is diagnosed and treated through laparoscopy surgery. This surgery is the only way to truly know if a woman has endometriosis, as excess endometrial tissue won’t show up on ultrasounds. 

Additionally, due to the hormone imbalance that potentially causes endometriosis, many women are given progesterone medications to help balance hormones and relieve symptoms. This is a fairly common treatment as many women with endometriosis also have low progesterone. 

How does endometriosis impact fertility?

Many women with endometriosis have no issues getting pregnant and, in fact, many women say that pregnancy improved their endometriosis symptoms. However, anywhere from one-third to one-half of women with endometriosis struggle to get pregnant. 

If the endometrial tissue is found on the fallopian tubes or ovaries, ovulation may not occur. Blocked fallopian tubes are common in women with endometriosis and can prevent the egg and sperm from meeting. As we know, it’s very hard to get pregnant without ovulation.

Can Proov help?

Yes! Since Proov confirms ovulation, it can help women with endometriosis confirm if they are or are not ovulating - critical information if they are trying to conceive. Proov measures PdG, the urine metabolite of progesterone. Progesterone is produced by the empty follicle after ovulation has occurred and PdG is only metabolized in urine if progesterone is present in blood. 

A single positive Proov test confirms ovulation and four positive test days 7, 8, 9, and 10 after suspected ovulation confirms that sufficient ovulation has occurred, meaning hormone levels post-ovulation remained elevated long enough to support implantation. 

If a woman with endometriosis never gets a positive Proov test, she can take this powerful information to her doctor to get treatment as soon as possible. Confirming ovulation with Proov can help women with endometriosis get pregnant that much faster!

Have questions about using Proov with endometriosis? Don’t hesitate to reach out to us at info@proovtest.com


Written by: Dr. Amy Beckley, PhD, Founder and Inventor of the Proov test – the first and only FDA-cleared test to confirm successful ovulation at home.