Does endometriosis affect pregnancy?

Written by Zhang Lu
Obstetrics
Updated on February 28, 2025
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Endometriosis is a common gynecological condition, which involves the implantation of endometrial tissue outside the uterine cavity. Endometriosis is a common cause of infertility: Firstly, when endometriosis occurs, it often affects the function of the ovaries. For example, ovarian chocolate cysts can affect the release of endocrine hormones in the ovaries, as well as cause ovarian ovulation disorders or premature ovarian failure. Secondly, endometriosis can cause inflammation in the pelvic cavity and adhesions within the pelvis. This will impact the function of the fallopian tubes, causing ovulation disorders in the tubes, as well as disorders in the transport function of the tubes. This can prevent fertilization, or after the sperm and egg have combined, the fallopian tubes may not be able to transport the fertilized egg to the uterine cavity, thus increasing the risk of ectopic pregnancy.

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Written by Yue Hua
Obstetrics and Gynecology
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Is endometriosis serious?

Endometriosis is a condition where the endometrium, which normally lines the uterus and has growth potential, is found outside of the uterine cavity, commonly in the ovaries. The typical clinical manifestation of endometriosis is abdominal pain during menstruation. Such pain intensifies as the condition progresses and can ultimately impact the patient's work and daily life, to the extent that they may not be able to work normally. Thus, endometriosis can become quite severe over time and may lead to infertility in women who wish to conceive.

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Written by Zhang Xiu Rong
Obstetrics and Gynecology
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What tests are done for endometriosis?

Endometriosis is generally diagnosed through color ultrasound and CA-125 blood tests. If the endometrial tissue is located within the uterine muscle, it forms adenomyosis, at which point the ultrasound will show an enlarged uterus and uneven muscle wall echogenicity. Blood tests for the tumor marker CA-125, if elevated above the normal level of 35, generally indicate adenomyosis. If the endometrial tissue is located in the ovaries, it can form ovarian chocolate cysts, which are visible on the ultrasound as ovarian sections and echoes, with typical ultrasound reports indicating ovarian chocolate cysts. Therefore, routine examinations for endometriosis typically include color ultrasound and blood tests, which can confirm the diagnosis.

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Written by Xu Xiao Ming
Obstetrics and Gynecology
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Endometriosis

Endometriosis means that the endometrial tissue, which normally lines the uterus, grows in other locations. It can grow on the ovaries, inside the muscular layer of the uterus, or in the pelvic cavity. The ectopic endometrial tissue responds to changes in the body's estrogen levels during each menstrual cycle, creating symptoms similar to menstrual bleeding. If it grows on the ovaries, it may form a "chocolate cyst" on the ovaries that gradually enlarges with each menstrual cycle. If it grows within the muscular layer of the uterus, it can lead to adenomyosis, causing significant pain during menstruation. If it grows in the pelvic cavity, it can lead to the formation of pelvic lesions. Therefore, it is recommended that patients with such conditions seek prompt medical treatment.

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Written by Shen Li Wen
Obstetrics and Gynecology
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Does endometriosis hurt?

When a woman has endometriosis, she rarely experiences pain outside of her menstrual period, except in specific circumstances, such as during intercourse, where contact might be made with the ectopic endometrial lesions, causing severe pain, also known as dyspareunia. During menstruation, because the ectopic endometrial tissue is still active, it can undergo congestion, edema, rupture, and bleeding, leading to severe dysmenorrhea. Additionally, during the menstrual period, it can also cause an increase in prostaglandin secretion within the uterine cavity, enhancing the uterus's excitability, leading to dysmenorrhea.

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Written by Xu Xiao Ming
Obstetrics and Gynecology
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Causes of endometriosis

The causes of endometriosis are not yet fully understood, but the theory of endometrial implantation is recognized by most experts and scholars. The main reason is that during menstruation, endometrial glandular epithelium and stromal cells can retrograde with menstrual blood, enter the pelvic cavity through the fallopian tubes, implant on the ovaries and adjacent pelvic peritoneum, and grow and spread there, forming pelvic endometriosis. Most clinical and experimental data also support this theory, indicating that approximately 70%-90% of women experience menstrual blood retrograde. Additionally, congenital vaginal atresia can also lead to endometriosis, as well as iatrogenic endometrial implantation, such as abdominal scar implantation after cesarean section or endometriosis at the perineal incision site after childbirth. These factors may also contribute to the development of endometriosis.