Causes & Treatment

Care, diet and proper testing – a medical director’s endometriosis and fertility toolkit

Jessie Day, in partnership with TFP Fertility UK  |   17 Mar 2023

Endometriosis and fertility. It’s one of our biggest searches, when trying to conceive – and no surprise there, given around 10% of women will have endometriosis during their reproductive years. That, plus the now outdated guidance that getting pregnant with endometriosis will ‘likely’ be a struggle. Put simply, every case is unique, and endometriosis is by no means a hard stop on fertility.

Endometriosis and fertility

Endometriosis UK note that even with severe endometriosis, ‘natural conception is still possible’ and that an estimated ‘60-70% of those with endometriosis can get pregnant spontaneously.’

We love a tool kit, and concrete, practical steps we can take to move our TTC journey forward. Whether it’s endometriosis (if so, do check out the potential significance of BCL6 and testing), PCOS, both or something else, it’s about advocating, and going after the latest in gold standard treatment.

Getting pregnant with endometriosis requires a focused action plan, tailored to your age, condition, the stage you’re at, and your fertility goals. And for action planning, time and again we look to the team at TFP Fertility UK, for full-service treatment, and a plan completely dedicated to us as individual cases.

We caught up with TFP Fertility UK Medical Director Dr James Hopkisson to put together the deep-dive endometriosis and fertility toolkit. From age factor to specialist treatment, the role of diet and more, this is the plan to pin, share and refer back to.

Over to Dr Hopkisson (and catch our endometriosis and fertility Q&A once you’re done).


1. Push for more detail, and proper testing

Women can, most certainly, have a successful pregnancy with endometriosis.

Endometriosis is a spectrum of disease, and it’s very important to understand how we might grade the disease, and how this affects the overall picture of your fertility. So my first advice, for people asking about endometriosis and fertility, is to push for this information from your doctor or team. It is never as simple as ‘just having endometriosis’. We – and, more importantly, you – need to know, is it mild, moderate or severe?

Once we know this, we can work on a plan that’s dedicated specifically to your condition and situation.

Many people don’t know that, depending on the stage of endometriosis and its effect on your pelvis, and especially with treatment for superficial disease, it is very possible to get pregnant naturally, without IVF. So it’s vital that we understand what stage you’re at, and how your endometriosis is developing.

2. See age as a factor, and leave it at that

Anyone who’s on a fertility journey knows the importance of age. But alongside this, trying to conceive is a very personal decision. We know that fertility treatment success rates are higher for younger patients, but equally, it has to be the right time for you.

If you’re diagnosed with endometriosis in your late twenties, it helps to be fertility-aware. But it’s not as simple as advising people to get going with TTC then and there. You need to be in the right place to start a family.

This is about keeping the facts around age in mind, looking at where you are – and what you want – what your fertility aspirations are and staying on top of your endometriosis, with your medical team.

3. Pick your team carefully

For people with endometriosis who are aiming to get pregnant, the essential principles of care are going to be the same. You need to be empowered to make informed decisions about your fertility journey. And from there, you need a personalised treatment plan, an idea of success rates, costs – physically, emotionally and financially and expert signposting to the right treatment options.

So, your care team or gynaecologist should have an interest and expertise in both fertility and endometriosis. And if you do need treatment or surgery for endo, it’s very important that your practitioner:

  • is aware and supportive of your fertility aspirations
  • experienced in dealing with all levels of endometriosis, day-in, day-out
  • works with a multidisciplinary team

They say ‘find your tribe’ when working through a fertility journey, and the principle is the same for finding the right medical team for you – we can absolutely support you with this, and at a local level.


4. Work on a good BMI, and overall wellness

This is important for all fertility patients. But if you’re preparing for a laparoscopy, for example, being fit and healthy, with a body mass index (BMI) in the right range will make recovery from surgery and anaesthesia much easier.

The NHS has a great calculator to quickly check your BMI at home, but your care team should also be prepped to support in this area. Surgery and a fertility journey can ask a lot of your body, so it’s very important you’re in the right place, and feeling strong on your treatment path.

5. Focus on diet and nutrition

I’ve had many patients who’ve successfully altered their endometriosis symptoms by changing their diet. It’s quite incredible. So I do recommend looking at your diet, perhaps working with a nutritionist, and seeing which foods may be aggravating your endometriosis.

There’s a real cross-over between endometriosis and bowel issues, including conditions like irritable bowel syndrome (IBS) and Coeliac Disease. Frustratingly, we see many patients whose endometriosis has been confused with IBS, delaying the support they need.

So, I’d say it needs to be a holistic approach. Don’t ignore diet, and if you find something within a nutrition protocol that decreases your pain by five per cent, do it! It doesn’t matter if it’s not working for 200 other people, if it’s working for you. From the FODMAP diet to supplements and other approaches, a nutritionist-supported approach may help you make dynamic changes to your endometriosis and inflammatory response.

Don’t accept delay, or dead-ends

Wrapping it all up, it’s important to stress that gynaecology as a speciality isn’t given sufficient focus, even in 2023. 50 per cent of the population are women, but central funding doesn’t seem to acknowledge that. It’s something I’m very passionate about – along with my team at TFP Fertility UK – and so our top three tips, for getting pregnant with endometriosis are:

  1. push for the right advice, from a specialist in both endometriosis and fertility
  2. keep up your fitness and whole-body wellness
  3. know that there is always something we can do, for your quality of life and fertility

We just need to speak to you – in person or by phone – to help you.

Head to TFP Fertility UK or call them at 0808 2234128 to connect with the amazing team, and build a plan that’s dedicated to your fertility and endometriosis journey.

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