If I need fertility treatment, is it more likely to succeed if I have endometriosis surgery first?

‘Endometriosis surgery’ usually refers to a laparoscopy: an operation that involves removing as much as possible of any endometriosis patches and scar tissue found within the pelvis.

Studies have shown that people with infertility problems were more likely to fall pregnant after endometriosis surgery than those who didn’t have the surgery. For this reason, it’s common for people with endometriosis (or suspected of having the condition) to get referred for laparoscopic surgery as part of their fertility treatment.

During surgery, the surgeon should be able to inspect various parts of the reproductive organs to see if there’s any endometriosis growing there, and if it’s caused any scarring or adhesions. This will give them an idea of the extent to which endometriosis might affect the patient’s chances of getting pregnant. Generally speaking, the more extensive the endometriosis, the more likely it is that fertility will be affected.

If the surgery is a ‘see and treat’ laparoscopy, the surgeon will try to remove as much as possible of the cells and damage they can see during the operation. This should make it easier for eggs to reach the womb successfully and provide a healthier environment for the egg to be fertilised. If the operation is a diagnostic laparoscopy, the patient may need to be referred for additional specialist surgery to remove the cells later on.

There are lots of other factors involved in becoming pregnant that wouldn’t be determined by laparoscopic surgery. For example, the surgeon won’t be able to see how many eggs are inside the ovaries or be able to tell how likely those eggs would be to fertilise.

A gynaecologist might also suggest starting other treatments to improve the chances of falling pregnant after the surgery, such as in vitro fertilisation (IVF).