Endometriosis is normally staged according to its severity and likelihood to cause infertility, from minimal-stage 1 to severe-stage 4. It can affect fertility in different ways:

•Inflammatory processes within the pelvic cavity

•Failed or impaired fertilization of the egg or implantation of the embryo

•Physical damage to important reproductive organs such as the fallopian tubes (scarring, blockage of the fallopian tubes, immobility of the ovaries)

Endometriosis can be diagnosed by several ways. Your physician may have a strong suspicion that you have endometriosis based on your symptoms but actual confirmation of the condition can only be made by seeing it through ultrasound or at surgery and/or performing a biopsy (sample taken at surgery and analyzed). Sometimes, collections of endometriosis can be seen on ultrasound when it is located on the ovary (called endometriomas or chocolate cysts). Other times, the endometriosis is too small to see on ultrasound but can be seen at surgery. Even very small amounts of endometriosis can be associated with pelvic pain and infertility.

Treatment
Endometriosis is often surgically removed during a laparoscopy. A fertility specialist will remove all endometriosis lesions that hinder fertility. If endometriosis has resulted in significant scarring of the pelvis and/or fallopian tubes, IVF may be the best option for acheiving a pregnancy. Under those circumstances, tubal damage might be so severe that surgical repair may not be a viable option. Some women may choose medical therapy for management of endometriosis especially when experiencing pain. Most medical management is counterproductive for gaining a pregnancy during the use of the medication.