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If you have endometriosis, IVF, in-vitro fertilization, can help you take steps toward making your dreams of growing your family come to life. In fact, IVF can even temporarily help with endometriosis symptoms.

So, what does endometriosis look like exactly? What are uncommon and common symptoms of endometriosis? And how can IVF and endometriosis work together? In this article, we’re going to reveal the answers to all of these questions. 

What Does Endometriosis Look Like?

According to the World Health Organization (WHO), about 10% of women at reproductive age have been diagnosed with endometriosis. In many cases, endometriosis is a painful condition, characterized by uterine tissue growing outside of the uterus. 

Most commonly, this condition impacts the areas lining the pelvis, the ovaries, and the fallopian tubes. However, there are also a few different types of endometriosis, as described below.

Types of Endometriosis

The four most common types of endometriosis include superficial peritoneal endometriosis, endometriomas, deeply infiltrating endometriosis, and abdominal wall endometriosis.

Superficial Peritoneal Endometriosis

Superficial peritoneal endometriosis impacts the peritoneal, a thin membrane layer lining the pelvis and abdomen. Considered the least severe form of endometriosis, this type of this condition causes uterine tissue to grow and attach to the peritoneal.


Endometriomas, on the other hand, includes “chocolate,” dark-colored, cysts in the abdomen and pelvis. Most commonly, these fluid-filled sacs are found on the ovaries, which can explain some fertility issues.

Deeply Infiltrating Endometriosis

With deeply infiltrating endometriosis, the uterine tissue has spread to the organs within the pelvis, such as the bladder, ovaries, rectum, and bowels. In rare cases, this tissue can cause some organs to become stuck together, causing pain and other discomforts, and is known as a “frozen pelvis.”

Abdominal Wall Endometriosis

In this type of endometriosis, the tissue affixes to the abdominal wall. Most often, it begins to grow on scar tissue, such as that from recent surgery or a C-section.

Stages of Endometriosis

There are further differing levels of severity in regards to endometriosis. The stages of endometriosis are measured based on endometrial tissue, the areas of the body impacts, and the depth of the tissue. These stages are explored in more detail below.

Stage 1 Endometriosis

Stage 1 endometriosis is known as the more “minimal” stage. This simply means that there are a few areas of tissue outside of the uterus, which are often quite small. This tissue often impacts the abdomen or pelvis, but it doesn’t leave any scarring at this stage.

Stage 2 Endometriosis

In stage 2 endometriosis, a more mild appearance of symptoms and tissue occurs. It also tends to appear deeper in the tissue, and it may leave some scarring.

Stage 3 Endometriosis

In this more moderate stage of endometriosis, there are more deep implantations of uterine tissue. Cysts may also be present, as well as thicker scar tissue (often called “adhesions”).

Stage 4 Endometriosis

This is the most severe and widespread stage of endometriosis. Thick scar tissue is common, along with deep invasion of the uterine tissue. Large and multiple cysts may also appear on the ovaries and other areas.

Signs of Endometriosis

The symptoms and signs of endometriosis may greatly vary, depending on the stage and type of endometriosis you have. In the following sections, we take a closer look at the common and uncommon symptoms of endometriosis.

Common Symptoms of Endometriosis

Many women with endometriosis experience the following common symptoms:

  • Painful periods
  • Pain with sex, bowel movements, and/or urination
  • Heavy menstrual periods
  • Infertility
  • Fatigue
  • Constipation
  • Diarrhea
  • Bloating
  • Nausea

Specifically, the last five symptoms tend to happen during a woman’s menstrual cycle. It’s also important to note that different women may experience different symptoms and that, again, it may depend on the stage and type of endometriosis you have been diagnosed with.

Uncommon Symptoms of Endometriosis

Less common endometriosis symptoms may involve:

  • Back pain
  • Breathing difficulties
  • Chest pain
  • Hip or leg pain
  • Nerve pain

Does Endometriosis Cause Infertility?

Research indicates that about 30 to 50% of individuals with endometriosis may face fertility issues. This is because this condition tends to impact the reproductive organs, causing cysts, inflammation, or scarring on the ovaries, fallopian tubes, and more.=

Depending on the stage of endometriosis you have, your infertility may vary, as well as the treatment recommended to you for it.

Stage 1 Endometriosis and Fertility

For stage 1 and 2 of endometriosis, it’s relatively unclear as to how fertility is impacted. It seems that infertility often coincides with those diagnosed with stage 3 or 4 endometriosis. 

This is partially why for stages 1 and 2, you may be recommended certain medications or hormones, as well as IUI, intrauterine insemination.

Stage 2 Endometriosis and Fertility

Similar to stage 1, stage 2 endometriosis and fertility is really broadly defined. In fact, women with stage 1 or 2 may even become pregnant without the help of fertility treatments. However, it really depends and such treatments are often considered on a case-by-case basis. Additionally, research shows that for stages 1 and 2, IVF has a higher success rate.

Stage 3 Endometriosis and Fertility

Being diagnosed with stage 3 or 4 endometriosis may indicate that you will have more difficulty getting pregnant on your own. Yet, this doesn’t mean it’s impossible. There is hope. Research indicates that women with stage 3 and 4 endometriosis that underwent IVF had a success rate of 56.7% after 1-4 IVF cycles.

Stage 4 Endometriosis and Fertility

With stage 4 endometriosis, you may experience more difficulty getting pregnant than the other stages. This often requires advanced fertility treatment, such as IVF or surrogacy with IVF. With ELITE IVF, we can help you navigate the world of assisted reproductive technology (ART), guiding you through the entire process and provide you with the solutions you need in one place. 

Endometriosis Infertility Treatment

Endometriosis infertility treatment comes in all different forms. For some, medications or hormones can help with the process. For others, IVF, IUI, or endometriosis excision surgery may be more viable options.

Endometriosis Excision Surgery

Endometriosis excision surgery involves the removal of endometriosis growths and scar tissue. Alternatively, your surgeons may decide to destroy this tissue with heat. Ultimately, the goal is to remove abnormal growths, leaving behind healthy tissue and helping reduce symptoms while potentially boosting fertility.

Does IVF Work with Endometriosis?

IVF works well for many individuals with endometriosis. In fact, it’s often the recommended solution, particularly for those diagnosed with stage 3 or 4 endometriosis. IVF involves the retrieval of eggs from the female and the collection of sperm from the male. From there, the sperm and eggs are combined in a lab to form an embryo. After they are grown to a sufficient size, the embryo is then transferred into the female’s uterus.

IVF After Endometriosis Surgery

Endometriosis surgery can help improve your chances of becoming pregnant. However, optimal recovery post-surgery is key. Studies indicate that the optimal time for IVF after endometriosis surgery is between seven and 25 months, depending on your recovery, the severity of your surgery, and your overall health.

Endometriosis and IVF Success Rates

Research shows that IVF success rates were lower for stage 3 and 4 endometriosis when compared to stage 1 and 2. However, this may vary depending on the type of endometriosis, a s well as whether or not surgery has taken place and when. There are also further variable factors in terms of implantation success versus live births.

IVF Success with Stage 4 Endometriosis

When specifically discussing IVF success with stage 4 endometriosis, studies show successful frozen embryo transfer for 56.7% of women, with 40.3% of women going on to have live births.

If you are facing an endometriosis diagnosis but wish to start a family, ELITE IVF is here for you. Our experts can guide you through your fertility journey, helping you determine the best options for you and your specific situation. Contact us today to get started.


Speak with a fertility specialist at ELITE IVF today!