Endometriosis & Fertility: What You Need to Know About TTC with Endo
Trying to conceive with endometriosis can feel like you’re navigating a maze without a map. Maybe you’ve heard it’s “impossible” to get pregnant naturally, or you’ve been told to try IVF right away. But the truth is—you have more options than you might think.
While endometriosis can make conception more challenging, many people with endo go on to conceive naturally or with the right support. Whether you’ve had a diagnosis for years or are newly navigating what it means for your fertility, this post will walk you through what’s really going on with endometriosis and fertility—and what you can do about it.
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🌿 How Endometriosis Affects Fertility
Endometriosis is more than just “painful periods.” It’s a chronic inflammatory and immune condition where tissue similar to the uterine lining grows outside the uterus. These lesions can show up on the ovaries, fallopian tubes, intestines, or other organs, often causing pain—but they can also interfere with fertility in more subtle ways.
Here’s how endo can impact fertility:
Inflammation in the pelvic cavity may impair egg quality and implantation
Adhesions or scar tissue can affect the fallopian tubes or ovarian function
Progesterone resistance makes it harder to support implantation or carry a pregnancy
Autoimmune or immune dysregulation may affect embryo development or implantation
Oxidative stress can reduce egg quality
You don’t have to have severe stage 4 endo to experience these effects—even stage 1 or 2 can impact hormone function and fertility.
🔍 TTC with Endo: Things to Look Into
If you’re trying to conceive with endometriosis, it helps to take a whole-body approach—addressing not just the reproductive organs, but the hormone, gut, and immune systems, too.
Here’s what I look at with clients:
✅ Luteal Phase & Progesterone
Progesterone resistance is common in endo. Even if your levels look okay on labs, your cells may not be responding well—leading to short luteal phases, spotting, or early miscarriages.
Testing:
Mid-luteal progesterone bloodwork
DUTCH test for progesterone metabolites
BBT charting to assess luteal phase length
Support:
Nutrients like B6, magnesium, vitamin C, and zinc
Anti-inflammatory foods
Herbal or supplemental support (based on lab results)
✅ Estrogen Metabolism
Endo is estrogen-sensitive, and too much estrogen—or poor detox—can worsen symptoms and inflammation.
Testing:
DUTCH test (shows how your body breaks down and clears estrogen)
GI MAP (helps assess gut’s role in estrogen re-circulation via beta-glucuronidase)
Support:
Cruciferous veggies, broccoli sprouts, flax
Fiber + liver support (like calcium-D-glucarate, dandelion tea)
Gut health support
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✅ Inflammation & Gut Health
The gut and immune system play a huge role in endo and fertility. If your gut lining is compromised or your microbiome is imbalanced, inflammation can increase and hormone detox can be impaired.
Testing:
GI MAP to assess gut pathogens, inflammation, beta-glucuronidase
Zonulin or calprotectin (if using conventional labs)
Support:
Soothing nutrients (L-glutamine, zinc carnosine)
SIBO or dysbiosis protocols (if needed)
Prebiotic + probiotic strategy tailored to your test results
✅ Egg Quality & Oxidative Stress
Endometriosis is linked to higher levels of oxidative stress, which can affect egg quality. Supporting mitochondrial health and antioxidants is key—especially if you’re 30+ or TTC after surgery.
Support options:
CoQ10 (ubiquinol form)
NAC and alpha-lipoic acid (ALA)
Omega-3s (anti-inflammatory and egg quality support)
Vitamin E, selenium, and glutathione support
🧪 Functional Testing That Can Help
Here’s what I often use with clients TTC with endometriosis:
DUTCH hormone test → for progesterone, estrogen, cortisol & hormone metabolism
GI MAP → for inflammation, pathogens, and estrogen detox
HTMA (Hair Tissue Mineral Analysis) → for mineral depletion from inflammation or stress
Comprehensive bloodwork → to assess thyroid, vitamin D, iron, insulin, and more
These can help uncover the why behind the symptoms—so you’re not guessing.
Final Thoughts
Trying to conceive with endometriosis can be emotional, frustrating, and overwhelming. But you’re not broken, and pregnancy is still very possible with the right information and support.
You deserve more than a “try IVF and hope for the best” approach. Whether you’re preparing for conception naturally or want to optimize before IUI or IVF, supporting your hormones, gut, inflammation, and progesterone can give you a stronger foundation for a healthy pregnancy.
Want to take the guesswork out of fertility? Learn more about my fertility testing package!
