When choosing the best time for pregnancy, considerations might include peak fertility, lifestyle, financial circumstances, and the cost of fertility treatments. Because fertility declines with age, most experts recommend trying to conceive before 35.

People over 35 may have more difficulty getting pregnant and are more likely to experience miscarriage, stillbirth, and pre-term birth.

Endometriosis is a leading cause of infertility in females. While some people with endometriosis can naturally conceive, approximately 35–50% of females with the condition have infertility.

There are various factors to think of when planning the best time to get pregnant such as peak fertility and lifestyle readiness factors. It is also important to plan for the cost and time involved with infertility treatments.

This article will discuss how endometriosis affects pregnancy, the best age for pregnancy, and how to increase one’s chances of getting pregnant.

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According to the American College of Obstetricians and Gynecologists (ACOG), nearly 4 in 10 people with infertility also have endometriosis. Infertility is when someone cannot get pregnant after 1 or more years of trying to conceive, or around 6 months when age 35 or older.

There are multiple ways that endometriosis can affect fertility and make it harder to get pregnant.

Adhesions and scar tissue from endometriosis growth can block the fallopian tubes and make it difficult for the egg and sperm to meet.

Endometriomas, a type of ovarian cyst, can grow in the ovaries and damage the ovarian reserve. This can negatively affect the quality of the eggs.

Additionally, endometriosis can cause inflammation, which can hurt fertility. It can also affect the uterine lining and decrease implantation.

Other theories include the following:

  • Endometriosis growth on the ovaries damages the egg reserve.
  • The immune system attacks the embryo.
  • The endometrium does not develop properly.

There are several factors to consider when choosing what age to get pregnant.

One factor is fertility, or the ability to conceive. Females are most fertile in their late teens and 20s. Fertility starts to decline in the late 20s and early 30s. This decline becomes more pronounced in the mid to late 30s, and even more so beyond the age of 40.

Despite this, there is no “perfect” age to get pregnant, and individuals need to consider a wide range of factors when deciding to have a baby.

Planned Parenthood suggests thinking of the following:

  • readiness for the full responsibility of raising a child
  • safety and health of a child’s environment
  • ability to afford raising a child
  • if someone or others are helping to raise the child, and how parenting will be shared
  • amount of support from others
  • how a child impacts one’s own future and family
  • ability to care for one’s own health for a healthy pregnancy and child

Choosing what age to get pregnant is a very individual decision that will not be the same for everyone. However, it is important for people with endometriosis to be aware of their fertility in order to advocate for themselves and make informed decisions.

According to a 2022 review, experts estimate that around 50% of females with mild endometriosis and 25% with moderate endometriosis will get pregnant without treatment. Around 35–50% of people with endometriosis have infertility.

As age increases fertility declines, and the risks of having pregnancy complications increase. People older than 35 have a higher risk of miscarriage, stillbirth, preterm birth, and other pregnancy complications like gestational diabetes and high blood pressure.

Many people with endometriosis can conceive naturally, and there is no single perfect age for a person with the condition to get pregnant. While a person’s doctor may recommend trying to get pregnant earlier, it is difficult to know a person’s fertility status until they start trying to conceive.

Someone struggling to get pregnant should talk with their doctor about doing an evaluation and possibly discussing treatment options.

Treatments and outcomes vary based on age. Females in their 20s may have a 50% or higher likelihood of pregnancy after one in vitro fertilization (IVF) attempt, while females in their 40s have a 10% chance after one attempt.

When considering fertility treatment, discuss options, cost, and timing with a doctor.

There are a few ways to increase one’s chances of getting pregnant with endometriosis. Maintaining a healthy diet and weight, exercising regularly, and avoiding alcohol and smoking are all beneficial.

There is little research about diets to improve fertility specifically for people with endometriosis. However, some people find that dietary and lifestyle changes positively affect their fertility. Most experts agree that more research is needed in this area.

There are also several therapeutic options, including surgery, medication, and assisted reproductive technology (ART).


Surgery aims to remove endometriosis tissue and restore typical anatomy. According to a 2020 critical review and analysis, research has shown that surgery may improve fertility and live birth rates in people with mild to moderate endometriosis.

However, surgery comes with risks including bleeding, infection, and damage to the ovaries and ovarian reserve. This can affect fertility.

A person’s doctor can help them weigh the pros and cons of surgery.


Some medicines aim to stimulate the ovaries and induce ovulation. A doctor may use these medicines before ART to increase the chance of pregnancy.

Assisted reproductive technology

Examples of ART include intrauterine insemination (IUI) and in vitro fertilization (IVF).

During IUI, sperm is inserted into the uterus. It is sometimes with a medication that stimulates the ovaries. However, IUI may not be effective for people with severe endometriosis.

In IVF, a doctor uses medications to stimulate the ovaries and harvest eggs. They then fertilize eggs with sperm and implant the resulting embryos into a person’s uterus. Some people choose to freeze embryos for later use.

Learn more about ART.

It is important that people with endometriosis are informed about their health and fertility status when deciding to get pregnant.

An OB-GYN can help someone plan for pregnancy by discussing things like personal and medical history, lifestyle, and medications. They can also discuss the best next steps for people with infertility.

People can prepare questions in advance, such as:

  • Is there an ideal window for me to get pregnant?
  • Based on my scans, symptoms, and test results, what do you think my fertility status is?
  • How can I gain more information about my fertility status before I try to get pregnant?
  • How long should I try to get pregnant before discussing medications and ART?
  • Will my current endometriosis treatments, like hormone therapy, affect my likelihood of getting pregnant?
  • How long will ART take, and much will it cost?

Endometriosis can make it harder to get pregnant. While some people with endometriosis can naturally conceive, others have infertility.

When choosing the best time to get pregnant, considerations include lifestyle factors like readiness, environment, and finances, as well as ideal fertility. Peak fertility occurs in the late teens and 20s, but fertility quickly declines in the mid-30s, making it more difficult to get pregnant.

Ask a doctor any questions about pregnancy with endometriosis and infertility treatment options.