Q. I’ve suffered from mild endometriosis for many years. Now that my husband and I are hoping to start a family soon, is it possible the endometriosis will cause problems when I’m trying to get pregnant?
A. It remains controversial whether mild cases of endometriosis can contribute significantly to infertility. Severe endometriosis causes adhesions (scar tissue) to develop around the ovaries, causing obvious problems in getting the ovulated egg into the fallopian tube. But mild or minimal endometriosis doesn’t cause any significant anatomical problems. However, even mild endometriosis is associated with the presence of proteins, white blood cells, and other factors that may affect fertilization and implantation. Some studies have shown improved pregnancy rates following surgical destruction or removal of the adhesions even in mild endometriosis, but so far there is no agreement as to whether or not this surgery (laparoscopy) is justified. Consult your physician for advice before you and your husband start trying. Depending on your age, the severity of your endometriosis, and other factors, your doctor may want you to start trying on your own for a certain amount of time before recommending any further treatment.