On the other hand, many women with endometriosis have no symptoms at all, and the condition may be discovered inadvertently during surgery for another reason. Infertility has long been felt to be associated with endometriosis, but the reason endometriosis might cause difficulty getting pregnant has not been established. In fact, it may be that the cause of the endometriosis may also independently cause infertility. Therefore, the presence of endometriosis does not, per se, imply that a woman can not get pregnant. However, it does appear that the chance of getting pregnant is decreased somewhat if you have endometriosis, and the more endometriosis you have, the less likely you are to get pregnant.
Endometriosis appears to start as small areas of abnormally situated endometrial lining cells.
As the tissue grows and bleeds, scar tissue forms around it, increasing the amount of damaged tissue. The scar tissue may even grow around the tubes and ovaries in a way that blocks the passage of the egg down the tube. For women who have severe endometriosis, where extensive scarring, blockage of the fallopian tubes, and large cysts in the ovaries are present, it is not hard to understand why pregnancy rates are extremely low without treatment. Endometriosis may be suspected if tender, thickened areas are felt near the uterus on a pelvic examination. If an ovarian cyst is present, sometimes a sonogram may exhibit the patterns suggestive of an endometrioma, and the diagnosis may then be suspected.