A 30-year population study conducted as part of the EU FEMaLe (Finding Endometriosis through Machine Learning) project has revealed an unexpectedly positive outcome for women with infertility associated with endometriosis. Published in July 2025, this extensive research harnessed linked healthcare records of over 4 million women in England to investigate infertility and pregnancy outcomes.
Study Design and Cohort
The study analyzed primary care, secondary care, and maternity records from 1991 to 2020 for women aged 13 to 50 who presented with infertility or symptoms related to endometriosis. Of the 4,041,770 women in the cohort, 245,994 had infertility diagnoses, with 111,197 having surgically confirmed endometriosis through laparoscopy or laparotomy.
Key Findings
Higher Pregnancy Rates Among Endometriosis-Associated Infertility
Women whose infertility was linked to endometriosis had a four-fold higher chance of achieving pregnancy during the study period compared to women whose infertility stemmed from other causes such as ovulatory dysfunction, tubal factors, or unexplained infertility.
In total, 40.5% of women with endometriosis reported at least one pregnancy during the 30 years of observation. This counters the common perception that endometriosis-associated infertility invariably results in poor fertility outcomes.
Possible Explanations
Experts suggest several reasons for this encouraging finding:
- Many cases of endometriosis in the studied cohort may have been mild or effectively managed.
- Surgical treatments like laparoscopic excision of endometriosis lesions are associated with improved pregnancy rates in some women.
- Heightened awareness about endometriosis and fertility may lead affected women to seek fertility assistance and interventions sooner.
Clinical Implications and Patient Reassurance
These results provide significant reassurance to affected women and healthcare providers. They underscore the importance of:
- Early diagnosis of endometriosis to enable timely tailored treatment.
- Personalized fertility counseling based on evidence, acknowledging the varied reproductive potential among women with endometriosis.
- Continued research into disease stage, lesion location, and intervention effects on fertility.
Conclusion
This extensive, population-level evidence challenges the deterministic view of infertility in endometriosis patients and highlights a nuanced understanding of fertility potential. By fostering early diagnosis and individualized care, healthcare systems can support better reproductive outcomes and provide hope to millions of women affected by this complex condition.
Sources
- MedicalXpress. Endometriosis linked to four-times higher pregnancy rates than other causes of infertility. July 2, 2025. Available at: https://medicalxpress.com/news/2025-07-endometriosis-linked-higher-pregnancy-infertility.html
- EU FEMaLe Project. Finding Endometriosis through Machine Learning. Available at: https://findingendometriosis.eu
- Human Reproduction. Pregnancy outcomes in women with endometriosis-associated infertility: a population-based study. Presented at ESHRE 2025 conference.
- University of Aberdeen. Research on Endometriosis and Fertility Outcomes. Lead by Dr. Lucky Saraswat. Available at: https://www.abdn.ac.uk/womens-health-research/
