Conceiving Naturally with Endometriosis and Adenomyosis: Self-Help Strategies

Are you desiring to conceive while grappling with the challenges of an endometriosis or adenomyosis diagnosis? You are not alone; many in our community share these concerns.

Below, we have compiled valuable insights and practical tips on achieving a natural pregnancy despite endometriosis or adenomyosis.


The term natural in this context differentiates it from artificial insemination. We also briefly touch upon surgical options as a potential therapeutic approach later in the article.

Throughout the rest of this article, we will primarily refer to “endometriosis,” with adenomyosis included as a subtype, given its distinct mechanisms of action.

Diagnosing Endometriosis

Endometriosis, a chronic yet benign condition, typically manifests between a person’s first menstrual cycle and menopause. It stands as one of the most prevalent gynecological disorders. Consequently, it often coincides with the stage of life when the desire for children comes into play. In certain instances, the diagnosis only surfaces when fertility issues arise, as endometriosis, marked by inflammatory processes, among other factors, can impact fertility alongside symptoms like pain [1].

Adenomyosis, sometimes considered a subtype of endometriosis and occasionally treated as an independent condition, further complicates matters [2]. It coexists with endometriosis in approximately 80% of cases [3]. Significantly, adenomyosis can also adversely influence fertility [17].

Can You Achieve Natural Pregnancy Despite an Endometriosis Diagnosis?

Yes, it is possible to conceive naturally, even with an endometriosis diagnosis. While endometriosis can present challenges, it does not render natural pregnancy impossible. Between 50-70% of individuals with endometriosis can conceive without assistance. Remarkably, in cases where there is a desire for children, but fertility remains elusive, endometriosis is the diagnosis in only 20-50% of instances. Other factors contribute to the fertility challenge in at least 50-80% of such cases [4]. This statistic offers hope and encouragement.

Understanding How Endometriosis Can Impact Fertility

So, how does endometriosis affect fertility? The precise mechanisms behind infertility in individual cases have not been definitively established through scientific research. Multiple factors can be at play, often intertwining [5].

When endometriosis is diagnosed, endometrial-like tissue is found outside the uterine cavity. These endometriosis lesions are categorized into various subtypes based on their location. Interestingly, the location, subtype, and severity of endometriosis appear to influence the likelihood of achieving a (natural) pregnancy [6].

However, the exact impact of different forms of endometriosis, including adenomyosis, on fertility has not been definitively elucidated.

In addition to potential anatomical changes and functional limitations (such as contractility), factors like reduced oocyte (egg) quality and diminished oocyte reserve may play a role. Researchers concur that there is evidence of immune system involvement and dysfunction in individuals with endometriosis [6]. Local inflammatory processes within the abdominal region or a systemic inflammatory environment can exacerbate symptoms like pain and infertility [7].

Furthermore, the severe pain often experienced by those with endometriosis can significantly impact their sexual lives, affecting their desire to conceive [8].

As you can see, the causes of infertility in the context of endometriosis are multifaceted and not always straightforward. Endometriosis alone is not always the sole cause of fertility challenges, underscoring the importance of personalized treatment and a holistic perspective.

Can Surgery Enhance the Likelihood of a Natural Pregnancy?

Surgery, explicitly removing endometriosis lesions, is a surgical intervention. Therefore, it is perfectly understandable if you wish to take your time to contemplate this option and explore potential alternatives. The diagnosis of endometriosis can be profoundly impactful, both emotionally and in terms of how it reshapes your life.

It’s important to note that surgery can sometimes adversely impact ovarian reserve [5].  Nevertheless, when timed appropriately, surgery can also facilitate a natural pregnancy [6]. Considering your unique circumstances, determining the right time for such a procedure is a decision best made in consultation with endometriosis experts. Given the highly individual nature of each situation, there are no blanket recommendations regarding surgery at this juncture.

Additionally, we invite you to peruse testimonials from fellow members of our community for additional insights.

Making Informed Decisions

Do you want to assess your prospects for a natural pregnancy and explore suitable treatment options? Consider taking advantage of a personalized consultation early in your journey. For individuals with endometriosis, seeking consultation is advisable if your desire for a child remains unfulfilled after 6 months. Several factors, including the timing of your diagnosis, age, the type and severity of your condition, and other potential contributors to infertility (such as thyroid function and your partner’s sperm quality), can influence your situation. Understanding these factors is essential as they are intertwined with various treatment options.

In certified endometriosis centers, often found in university hospitals with specialized outpatient clinics, the primary focus is crafting individual, multimodal treatment plans designed to provide holistic support [2].

Enhancing Your Chances of a Natural Pregnancy

Sometimes, patients with endometriosis may encounter limitations when considering medication and surgical interventions. Consequently, alternative concepts and therapeutic approaches become worthy of consideration. It is crucial to note that the following tips are not meant to substitute for consultation and treatment in an endometriosis center. Nonetheless, they can complement your overall well-being and, by extension, positively influence your fertility throughout therapy.

Understanding and Monitoring Your Menstrual Cycle

In the context of fertility treatment or preparation for it, cycle monitoring becomes an essential part of the initial assessment. This process involves observing your menstrual cycle and conducting various hormone analyses, often done concurrently with an evaluation of sperm quality.

However, you can also take an active role in understanding your cycle independently. Evidence-based methods such as Natural Family Planning (NFP) or cycle tracking apps can be valuable tools. Self-monitoring empowers you to comprehend your process and pinpoint the optimal days for conception. Research has demonstrated that couples struggling with prolonged unfulfilled desires for pregnancy can benefit significantly from knowledge about the fertile window, ultimately increasing the likelihood of spontaneous pregnancy conception [9]

Given that endometriosis is frequently not solely responsible for infertility, paying close attention to your cycle and any irregularities is beneficial. To facilitate this, consider keeping a diary, whether it is in a physical journal or an online platform. Recording your observations, symptoms, and efforts will provide insights into what may be helpful or not in your unique situation.

Alternative Strategies to Support Natural Fertility

Currently, there is a lack of definitive studies showing that alternative therapeutic methods conclusively enhance fertility in individuals with endometriosis [10]. Nevertheless, many individuals with endometriosis have reported positive outcomes from combining therapies such as osteopathy, acupuncture, dietary adjustments, and stress management. These approaches often lead to a substantial improvement in overall quality of life. It is important to note that, due to a lack of scientific evidence in some cases, these services may not be fully covered by health insurance, though partial coverage may be available.

Here is a list of supportive measures commonly recommended by endometriosis specialists to complement therapy [3]:

Managing Pain and Coping Strategies

Beyond the cyclic and acyclic pain associated with endometriosis, it is worth noting that over 50% of individuals with endometriosis also endure intense pain during sexual intercourse [6],[8]. This can significantly strain the relationship and the desire to conceive. It is essential to recognize that regular sexual intercourse plays a crucial role in achieving spontaneous, natural pregnancy. Embracing a moderate and responsible approach to pain relief and learning effective pain management techniques can provide much-needed relief in your daily life and, if necessary, during sexual activity. Consider trying these strategies, but remember not to pressure yourself and allow yourself the time you need to adapt and find what works best for you.

Anti-Inflammatory and Well-Balanced Diet

Maintaining a healthy and diverse diet gives your body essential vitamins, minerals, and nutrients that contribute to overall vitality. (For general dietary recommendations, refer to the guidelines provided by the German Nutrition Society.) It is worth noting that such a diet has been scientifically shown to support fertility [11]. Essential nutrients often associated with fertility include folic acid, calcium, vitamin E, vitamin B12, and B6. Opting for a well-balanced, low-fat, and anti-inflammatory diet can positively influence the course of your therapy, aid in healing inflammation, and bolster your immune system.

These same nutrients, including folic acid, calcium, vitamin E, B12, and B6, play pivotal roles in childbearing.

Moreover, a balanced, low-fat, and inflammation-friendly diet can offer valuable support during your therapy, facilitate inflammation healing, and enhance your immune system. Adopting a gluten-free, high-fiber diet can contribute to intestinal health, which may be relevant in endometriosis [3].

In a German study, the impact of nutrition on both the development and manifestation of endometriosis was explored [12]. While the available study results do not provide a comprehensive dietary plan, there is some evidence of positive effects on endometriosis pain relief, mainly through fish oil capsules (omega-3 intake) combined with vitamin B12. Overall, nutritional interventions for managing endometriosis-related symptoms offer promising prospects, especially in alleviating pain. Nonetheless, further research is required in this area [13].

It is important to note that alcohol consumption and high intake of red meat and unsaturated fatty acids harm endometriosis. Moreover, regular alcohol consumption has been linked to reduced fertility, even independently of endometriosis [14].

Stress Management, Psychological Support, and Relaxation Techniques

It is essential to recognize that stress and the insomnia it frequently triggers can have a notable impact on fertility [15],[16]. Moreover, stress can impair your decision-making abilities because your brain remains in a heightened state of alertness, making clear thinking challenging. Engaging in practices like meditation, resilience training, breathing exercises, or appropriate yoga routines can assist you in establishing consistent moments of tranquility and serenity. These techniques can effectively mitigate stress. Psychological support and connecting with individuals who have experienced similar situations can offer valuable assistance and insight.


The journey of desiring a child while navigating endometriosis and adenomyosis is sensitive and intricate, with no singular correct path. It is highly advisable to seek an individual consultation at an endometriosis center promptly. While endometriosis and adenomyosis can influence fertility, the underlying mechanisms, which are partly interconnected, remain complex and subject to ongoing research. Nevertheless, it is essential to emphasize that natural pregnancy is still possible; many individuals with endometriosis successfully conceive without significant challenges. The treatment of endometriosis-related infertility demands a highly personalized approach.

On a personal level, you can maintain a balanced diet, develop strategies to manage pain, acquire relaxation techniques (such as yoga and breathing exercises), integrate physical activity into your daily routine, and be compassionate toward your needs and resources.

Have you had your own experiences with this topic? Please feel free to share them in the comments.

With the Endo-App, you can document your well-being on a daily basis.


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