Endometriosis and pregnancy: what studies show
Having a child, what changes during pregnancy, the risks in figures, care and what happens afterwards. With what is established, and what no one knows yet.
Written by Paul, a nurse, founder of EndoQueen, from a literature review carried out on 12 October 2026. This feature informs; it doesn’t replace an appointment and can’t estimate your personal risk.
In brief
- Most women with endometriosis have a child.
- During pregnancy, lesions often shrink. For pain, no study can say.
- Some complications are a little more frequent, but they remain rare.
- Pregnancy doesn’t cure endometriosis: pain most often comes back afterwards.
Can I have a child with endometriosis?
Yes, most often. In a large US study that followed 58,000 women for years, 83% of those with endometriosis had had a child by age 40. The risk of taking more than a year to conceive is about twice as high, especially before 35.
You may have read that “30 to 50% of women with endometriosis are infertile”. These figures come from older hospital studies, which only see women who seek care for this reason. Following all women gives a real risk, but about half as high.
Our guide on endometriosis and fertility explains when to see a doctor and how to prepare the appointment.
And if I have IVF?
Overall, large reviews find birth rates close to those of other women having IVF. They are a little lower in severe forms, with adenomyosis, or when another cause of infertility is added.
Two things to know before an operation:
- removing an ovarian cyst lowers the ovarian reserve, by about 40% on one side and 57% on both sides;
- no operation done before IVF has been shown to increase births, and the 2022 European guideline advises against it as a routine.
This choice is best discussed with a team that knows the disease. No study puts a figure on what an earlier diagnosis would change for fertility: we only know that age and how long you’ve been trying matter.
What happens to lesions during pregnancy?
Endometriosis feeds on oestrogen and bleeds with the rhythm of the cycle. During pregnancy, progesterone takes over and periods stop: the tissue of the lesions changes (doctors call it decidualisation), then thins.
The absence of periods and the progesterone put the disease to rest in many women. Ovarian cysts shrink in 7 to 8 cases out of 10, and deep nodules most often regress too, sometimes after growing in early pregnancy.
It’s the same principle as hormonal treatments for endometriosis, which try to reproduce this climate: no ovulation, no periods, and progesterone. In both cases, the disease is put to rest, not removed, and it can start again afterwards.
Three ultrasound follow-up studies, in expert centres, with small numbers. About 5% of cysts grow.
A cyst that changes appearance. Under the effect of hormones, some cysts change on ultrasound and can look like a tumour. It’s alarming, and almost always benign: it disappears after the birth. In that case, an opinion from a centre used to this situation is recommended.
Adenomyosis, for its part, becomes less visible on ultrasound during pregnancy, then reappears afterwards. It’s masked, not cured.
Will I have less endometriosis pain during pregnancy?
We don’t really know. No study has followed pain month by month during pregnancy. Many women get a break, if only because periods stop. Others are still in pain, and it isn’t in their head.
If you’re in pain during your pregnancy, note it and talk to your midwife or doctor: pain that lasts always deserves to be reported.
What are the risks?
Articles talk about a “doubled” or “tripled” risk. Here are the same results as a number of pregnancies out of 1,000. Compare the two bars on the same line, not one line with another: each country counts in its own way.
Large studies in Japan, Denmark and France (103 maternity units). Another, smaller French study finds no extra risk of preterm birth.
In other words, even in the French study, nearly 9 pregnancies out of 10 reach term. Deep forms and adenomyosis are the most concerned, and a pregnancy obtained through IVF adds a little risk.
Serious events, such as internal bleeding or a perforated bowel, are exceptional. Knowing about them mainly helps you not to brush aside a sudden pain.
What care during pregnancy?
The 2022 European guideline doesn’t provide for special pregnancy monitoring for endometriosis: it states that the complications, which are rare, don’t justify routine extra monitoring.
What helps most:
- telling your midwife and your maternity team about your diagnosis from the start;
- giving them your surgery, ultrasound or MRI reports;
- mentioning adenomyosis or any surgery on the womb, which can change how the birth is organised.
Painkillers
Paracetamol (called acetaminophen in North America) is the reference medicine throughout pregnancy. Anti-inflammatories such as ibuprofen are contraindicated from the sixth month, even as a single dose, and advised against before. For anything else, ask your doctor, midwife or pharmacist.
Call your maternity unit or your local emergency number straight away if you have:
- sudden or unusual belly pain, or you feel faint;
- bleeding;
- headaches, vision problems or a band-like pain under the ribs in the second half of pregnancy;
- a hard, painful belly;
- a baby moving less.
And always say: “I have endometriosis.”
And after the birth?
Pregnancy doesn’t cure endometriosis. Pain most often comes back, usually when periods return.
Study of 131 women who had had surgery and had moderate to severe pain before their pregnancy.
Breastfeeding seems to delay this return, in proportion to how long it lasts, though this hasn’t been proven. Endometriosis follow-up therefore starts again after the birth: it’s worth keeping your appointment, even if you feel well.
What we don’t know yet
- How pain changes during pregnancy, and what share of women get relief.
- The chances of natural pregnancy by age and type of lesion.
- What an earlier diagnosis would change for fertility.
- The best-suited pregnancy care: no trial has studied it.
Frequently asked questions
Can you have a baby with endometriosis?
Yes, most often. In a large US study, 83% of women with endometriosis had had a child by age 40. The risk of taking more than a year to conceive is about doubled, especially before 35.
Does pregnancy cure endometriosis?
No. Lesions often shrink during pregnancy, but pain comes back for most women within two years of the birth. The 2022 European guideline asks doctors not to recommend pregnancy as a treatment for endometriosis.
Do I need special pregnancy care with endometriosis?
The 2022 European guideline doesn’t provide for routine extra monitoring. The most useful step is to tell your midwife and maternity team about your diagnosis from the start, and to give them your surgery reports.
Which painkiller can I take while pregnant?
Paracetamol (acetaminophen) is the reference medicine throughout pregnancy. Anti-inflammatories such as ibuprofen are contraindicated from the sixth month, even as a single dose, and advised against before. For any other medicine, ask your doctor, midwife or pharmacist.
If it helps, EndoQueen is on iPhone and Android. A journal to note your pain and your cycles, and a one-page summary to show your doctor or midwife. It does not diagnose, and your journal stays on your phone. The app is currently in French; the English version arrives in November 2026. Discover the app
Read next
Sources
- Prescott et al., Human Reproduction, 2016: fertility in a cohort of 58,427 women
- ESHRE, Guideline: endometriosis, 2022
- Younis et al., Human Reproduction Update, 2019: ovarian reserve after cyst surgery
- Senapati et al., Fertility and Sterility, 2016: IVF outcomes
- Bean et al., 2023, Orlov et al., 2024, Takami et al., 2021: changes in lesions during pregnancy
- Leeners et al., Human Reproduction Update, 2018: effect of pregnancy on endometriosis
- Harada et al., PLoS One, 2019, Breintoft et al., 2022, Vendittelli et al., 2024, Marcellin et al., 2022: pregnancy complications
- Alberico et al., 2018, Prosperi Porta et al., 2021: after the birth
- CRAT, Painkillers and pregnancy (in French); ANSM, Treating pain during pregnancy (in French)
Most of these studies were read as abstracts. The figures are those published by their authors; they describe groups of women and predict nothing for any one person.
Last reviewed: 29 October 2026.