Questions to Ask About Fertility and Endometriosis

Fertility conversations can feel emotional, personal and time-sensitive. Preparing questions before an appointment can help you feel clearer and more in control. Endometriosis can affect fertility for some people, but not everyone with endometriosis will have difficulty getting pregnant. Fertility advice should be individual and should consider your symptoms, age, ovarian reserve, endometriomas, previous surgery, fallopian tubes, sperm or partner factors, treatment history and personal goals.

Start with what matters to you

Before the appointment, think about what you want help with. You may be asking because:

  • you want to try for pregnancy now
  • you may want children in the future
  • you have been trying to conceive
  • you have endometriomas
  • surgery has been suggested
  • IVF or assisted fertility treatment has been mentioned
  • you are worried treatment could affect ovarian reserve
  • you are unsure whether fertility preservation should be discussed

You do not need to know the answer before the appointment. The aim is to ask the right questions early.

Core questions to ask

You may want to ask:

  • Could endometriosis be affecting my fertility?
  • What else could be affecting fertility?
  • Should I have fertility tests?
  • Should ovarian reserve be checked?
  • Are my fallopian tubes likely to be affected?
  • Are endometriomas present?
  • Could adhesions or scarring be affecting my options?
  • Should sperm or partner factors be assessed too?
  • Should I be referred to a fertility specialist?
  • What should I do now if I want children later?

Questions about ovarian reserve

Ovarian reserve is a way of estimating how the ovaries may respond to fertility treatment. It does not predict everything about fertility, but it can be useful in planning. Ask:

  • Should I have ovarian reserve testing?
  • What do my AMH, AFC or other results mean?
  • Could endometriomas affect ovarian reserve?
  • Could previous surgery have affected ovarian reserve?
  • Could future ovarian surgery affect ovarian reserve?
  • Should fertility advice happen before surgery?

If surgery is discussed

Surgery may be helpful in some situations, but it can also carry risks, especially where the ovaries or endometriomas are involved. Ask:

  • What is the aim of surgery: pain relief, fertility, diagnosis, treatment, or all of these?
  • Could surgery improve my chance of pregnancy?
  • Could surgery affect ovarian reserve?
  • Are endometriomas involved?
  • Will surgery involve one ovary or both?
  • Should I see a fertility specialist before surgery?
  • Should fertility preservation be discussed first?
  • What happens if I choose fertility treatment before surgery?
  • What are the risks of waiting?

If IVF or fertility treatment is discussed

IVF may be appropriate for some people, but the plan should consider the endometriosis picture. Ask:

  • How might endometriosis affect IVF planning?
  • Should endometriomas be treated before IVF or monitored?
  • Could surgery help or harm my IVF chances?
  • What is the best sequence: surgery first, IVF first, or another approach?
  • How might pain or flares be managed during fertility treatment?
  • Are there risks linked with stimulation if I have endometriomas?
  • What happens if IVF is delayed because of symptoms or surgery?

If you want children later

Even if you are not trying now, it is reasonable to ask about future fertility. Ask:

  • What should I consider now if I may want children later?
  • Could my symptoms, scans or surgery history affect future fertility?
  • Should ovarian reserve be checked?
  • Should fertility preservation be discussed?
  • How might hormonal treatment affect timing?
  • When should I ask for review again?

Fertility preservation is not needed or suitable for everyone, but it is reasonable to ask whether it should be part of the conversation.

Questions about symptoms and imaging

Symptoms and imaging can affect fertility decisions, especially where endometriomas, deep disease or adhesions are suspected. Ask:

  • How do my symptoms affect fertility planning?
  • How do my imaging results affect options?
  • What can imaging show?
  • What can imaging miss?
  • Could normal scans still miss endometriosis?
  • Should specialist ultrasound or MRI be considered?
  • Should previous operation notes or histology be reviewed?

Prepare before you speak with a healthcare professional

Use our Prepare for Appointment Tool to organise your symptoms, fertility priorities, questions, previous treatments, scan results, surgery history and concerns before your appointment. Try to record how long you have been trying to conceive if relevant, cycle pattern, pain with sex, previous pregnancies or losses, known endometriomas, surgery history, fertility tests already done and what outcome matters most to you. You do not need a perfect diary. A clear summary can help the conversation feel more focused.

Finding the right type of care

Use the Endometriosis Care Directory to explore endometriosis-related care providers, including fertility specialists, endometriosis specialists and multidisciplinary clinics. The directory is for research and information only. It is not a recommendation, referral service, ranking or medical advice. Always check details directly with the provider and speak with an appropriate healthcare professional before making decisions about your care.

Final reminder

Fertility decisions with endometriosis should be individual, informed and timed around your goals. You deserve clear advice about ovarian reserve, endometriomas, surgery, IVF, fertility preservation, pain, imaging and referral options so you can make decisions with the right support. This resource is here to support your understanding, not replace medical advice from a qualified healthcare professional.