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Endometriosis and Fertility

  • rippleacupuncture
  • Aug 11
  • 6 min read
(FlindersFertility,2025)
(FlindersFertility,2025)

Endometriosis, where tissue similar to the uterine lining grows outside the uterus, can affect fertility. While many women with the condition can conceive, 30-50% may experience infertility. This is because it can cause scarring, cysts, and adhesions, which can disrupt ovulation, block fallopian tubes, or prevent a fertilized egg from implanting.

This displaced endometrial tissue, commonly found in the pelvis but also in areas like the bowel or bladder, responds to hormonal changes by thickening and bleeding, much like the uterine lining during a menstrual cycle. However, since the blood and tissue cannot exit the body, it leads to inflammation, pain, and sometimes scarring.


Distorted Pelvic Anatomy

Endometrial tissue outside the uterus can distort pelvic anatomy through inflammation, scar tissue, and adhesions. These changes can affect fertility by hindering egg release, fallopian tube function, and fertilized egg implantation.

Endometriosis is categorized into four stages, with higher stages generally indicating a greater presence of adhesions and larger cysts. However, the stage of endometriosis does not always correlate with symptom severity. Some women with severe endometriosis may experience minimal symptoms, while others with mild endometriosis may have severe pain.


Impaired ovulation

Endometriosis can impair ovulation. In severe cases, it can distort the ovaries and fallopian tubes, which prevents eggs from being released or traveling to the uterus. Additionally, endometriosis can cause inflammation and release chemicals that interfere with normal hormonal signals needed for ovulation.


Inflammation

This inflammation disrupts the normal functions of the ovaries, fallopian tubes, and uterus, and can also affect egg and embryo quality. The inflammation releases cytokines, which may prevent sperm and egg interaction, thereby inhibiting fertilization. Additionally, inflammation can lead to scarring and adhesions, potentially blocking or damaging the fallopian tubes, impeding ovulation, or hindering embryo implantation.


Reduced Implantation Rates

Endometriosis can make it harder for a fertilized egg to attach to the uterine lining, leading to reduced implantation rates. This is because the body's inflammatory response can disrupt the hormonal balance necessary for successful implantation.


Impact on IVF Success

 IVF has enabled many women with endometriosis to conceive. However, endometriosis can present challenges in IVF, especially in advanced stages. The presence of inflammation may negatively affect the quality of eggs and embryos, as well as the implantation process.


Challenges with diagnosis

Early surgical intervention for mild to moderate endometriosis may enhance natural conception rates. However, its effect on IVF success is less clear, and in some cases, surgery, especially for ovarian chocolate cysts, might pose risks to ovarian health, potentially resulting in diminished ovarian reserve for IVF. 

Diagnosing endometriosis is often delayed due to varied and subtle symptoms, the tendency to normalize period pain, and the limitations of ultrasound and MRI, which often necessitate laparoscopy—an invasive procedure—for confirmation. The absence of a specific blood or other reliable biomarker further complicates early identification.


Theory of Traditional Chinese Medicine (TCM)

In TCM, endometriosis is understood as a blood stagnation disorder. This occurs when the circulation of Qi and Blood in the pelvic area becomes obstructed, leading to a buildup of stagnant Blood and the manifestation of symptoms.

TCM practitioners diagnose and treat the root cause of this blood stagnation. Common patterns observed include Liver Qi stagnation, Spleen Qi deficiency, and Kidney Yang deficiency with cold in the uterus.

Essentially, TCM aims to identify what is hindering smooth blood circulation. To give an analogy, consider a delay on a train route, like from Newcastle to Sydney. This delay could be due to various factors such as driver-related problems, natural incidents, infrastructure issues, or even a lack of fuel. Similarly, TCM seeks to pinpoint the specific reasons for obstructed blood flow.

The goal of TCM is to regulate blood movement by addressing these underlying issues. Treatment often involves a combination of acupuncture, herbal medicine, and individualized diet and exercise plans.

Earlier intervention is much more effective when dealing with endometriosis. If you experience frequent symptoms like painful periods, pain during or after sex, painful urination or bowel movements, heavy or irregular bleeding, or have been unable to conceive after 12 months of regular, unprotected sexual intercourse, it's important to consult your GP.


I frequently encounter clients who are experiencing painful periods. Regardless of the specific reason a female client comes to see me, I always inquire about their menstrual cycle. This provides me with a valuable snapshot of their overall health. I understand that there's often a lack of open communication regarding period issues unless one is speaking with a doctor. This silence can unfortunately lead to women not seeking the necessary medical help for menstrual problems, even when they are experiencing severe pain or other complications. I firmly believe that empowering women with increased awareness could lead to earlier intervention, more effective symptom management, and a significant improvement in their quality of life.



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About the Author

Youngmi Choi

Ripple Acupuncture | Newcastle | New Lambton | Charlestown

As an AHPRA-registered acupuncturist with 15 years of nursing experience, I offer safe, effective, and holistic care. My special interests include pain management, psycho-emotional well-being, digestive balance, and women’s health & fertility. My approach is outcome-focused, and clients receive a clear care plan with personalized lifestyle advice.


If you have any questions about your period conditions, please make an online booking, submit an online enquiry or call me on 0402 474 884. 


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Reference

  1. Macer, M.L., & Taylor, H.S. Endometriosis and Infertility: A review of the pathogenesis and treatment of endometriosis-associated infertility. Obstetrics and gynecology clinics of North America, 2012; 39(4): 535 -549.  doi: 10.1016/j.ogc.2012.10.002

  2. Tomic, V., Kasum, M., & Vucic, K. Impact of embryo quality and endometrial thickness on implantation in natural cycle IVF.  Archives of gynecology and obstetrics, 2020; 301(5): 1325-1330. doi: 10.1007/s00404-020-05507-4

  3. World Health Organization (2023). Endometriosis; [reviewed 2025 Aug 11]. Available from: https://www.who.int/news-room/fact-sheets/detail/endometriosis

  4. Fini, E., Argento, F.R., Borghi, S. et al. Fibrinogen Structural Changes and Their Potential Role in Endometriosis-Related Thrombosis. Antioxidants, 2024; 13(12):1456. doi: 10.3390/antiox13121456. 

  5. Casalechi, M., Tripodi, A., Reis, F.M. et al. Journal of Endometriosis and Uterine Disorders. 2023;  3:100040. doi: 10.1016/j.jeud.2023.100040

  6. IVF Australia (2025). Endometriosis; [reviewed 2025 Aug 11]. Available from: https://www.ivf.com.au/planning-for-pregnancy/female-fertility/endometriosis#:~:text=How%20does%20endometriosis%20affect%20fertility,endometriosis%20can%20still%20conceive%20naturally

  7. Endometriosis Australia (2025). Fertility and Pregnancy;  [reviewed 2025 Aug 11]. Available from: https://endometriosisaustralia.org/blog/fertility-and-pregnancy/#:~:text=People%20with%20endometriosis%20may%20experience,outcomes%20for%20people%20with%20endometriosis.

  8. Jean Hailes for Women’s Health (2025). Endometriosis and fertility; [reviewed 2025 Aug 11]. Available from: https://www.jeanhailes.org.au/health-a-z/endometriosis/fertility#:~:text=Endometriosis%20may%20impact%20your%20fertility,may%20impact%20symptoms%20of%20endometriosis.

  9. Brigham and Women's Hospital (2025). Endometriosis and Fertility; [reviewed 2025 Aug 4]. Available from: https://www.brighamandwomens.org/obgyn/infertility-reproductive-surgery/endometriosis/endometriosis-and-fertility

  10. Bulletti, C., Coccia, M.E., Battistoni, S., & Borini, A. Endometriosis and infertility. Journal of Assisted Reproduction and Genetics, 2010; 27(8): 441-447. doi: 10.1007/s10815-010-9436-1. 

  11. Crump, J., Suker, A., & White, L. Endometriosis: A review of recent evidence and guidelines. Australian Journal of General Practice, 2024; 53(1-2). doi: 10.31128/AJGP/04-23-6805

  12. Bloski, T., & Person, R. Endometriosis and Chronic Pelvic Pain. Nursing for women's health, 2008; 12(5): 382-395.  doi: 10.1111/j.1751-486X.2008.00362.x.

  13. Endometriosis Treatment Center of America. The Four Stages of Endometriosis Explained; [reviewed 2025 Aug 4]. Available from: https://www.centerofendometriosis.com/blog/endometriosis-stages-etcoa-michigan/

  14. Rasheed, H.A. & Hamid, P. Inflammation to Infertility: Panoramic View on Endometriosis. Cureus, 2020; 12(11): e11516. doi: 10.7759/cureus.11516

  15. Park, W., Lim, W., Kim, M. et al. Female reproductive disease, endometriosis: From inflammation to infertility. Molecules and Cells, 2025; 48(1): 100164.https://doi.org/10.1016/j.mocell.2024.100164

  16. Zhong, C., Gao, L., Shu, L. et al. Analysis of IVF/ICSI Outcomes in Endometriosis Patients With Recurrent Implantation Failure: Influence on Cumulative Live Birth Rate. Frontiers in Endocrinology, 2021; 30(12):640288. doi: 10.3389/fendo.2021.640288. 

  17. Kuivasaari, P., Hipplelainen, M., Anttila, M., & Heinonen, S. Effect of endometriosis on IVF/ICSI outcome: stage III/IV endometriosis worsens cumulative pregnancy and live-born rates. Human Reproduction, 2005; 20(11): 3130-3135. https://doi.org/10.1093/humrep/dei176 

  18. Barnhart, K., Dunsmoor-Su, R., & Coutifaris, C. Effect of endometriosis on in vitro fertilization, 2022; 77(6): 1148-1155. https://doi.org/10.1016/S0015-0282(02)03112-6

  19. Australian Government: Department of Health, Disability and Ageing (2024). About endometriosis;  [reviewed 2025 Aug 4]. Available from: https://www.health.gov.au/topics/chronic-conditions/what-were-doing-about-chronic-conditions/what-were-doing-about-endometriosis#:~:text=Endometriosis%20is%20a%20chronic%20condition,infertility

  20. Sydney Endometriosis (2023). What Makes Endometriosis So Hard To Diagnose?; [reviewed 2025 Aug 4]. Available from: https://sydneyendometriosis.com.au/blog/what-makes-endometriosis-so-hard-to-diagnose/#:~:text=February%2024%2C%202023,condition%20all%20come%20into%20play.

  21. Endometriosis Australia (2022). Why is it so difficult to get an endometriosis diagnosis?; [reviewed 2025 Aug 4]. Available from: https://endometriosisaustralia.org/why-is-it-so-difficult-to-get-an-endometriosis-diagnosis/#:~:text=Around%20the%20world%2C%20many%20researchers,had%20any%20luck%20so%20far.

  22. Dr Ljiljana Miljkovic-Petkovic (2025). I Have Endometriosis. Can I Still Get Pregnant?; [reviewed 2025 Aug 4]. Available from: https://drljiljanamp.com.au/cervical-screening-changes-copy/#:~:text=Treatment%20Options%20for%20Endometriosis%2DRelated,t%20responded%20to%20other%20treatments.

  23. Rimbach, S., Ulrich, U., Schweppe, K.W. Surgical Therapy of Endometriosis: Challenges and Controversies. Geburtshilfe und Frauenheilkunde, 2013; 73(9): 918-923. doi: 10.1055/s-0033-1350890. 

  24. Llarena, N.C., Falcone, T., & Flyckt, R.L. Clinical medicine insights. Reproductive health, 2019; 13: 179558119873386. doi: 10.1177/1179558119873386



 
 
 

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