Suboptimal fertility may arise from reduced egg production, impaired egg transport and reduced coital frequency. All may apply in chronic pelvic pain with, or without, endometriosis. Ovarian cysts with endometriomas prevent regular ovulation, adhesions may impair movement of the Fallopian tube over the surface of the ovary, abnormal nerves in the Fallopian tube and uterus may prevent egg transport along the Fallopian tube and implantation in the uterus. If sex is painful then reduced frequency will reduce chances of conception.
Not only is pregnancy impaired in chronic pelvic pain with, or without, endometriosis but, if pregnancy does occur there complications include miscarriage, preeclampsia, poor growth, unexplained stillbirth – so it is not an easy situation for any woman or her clinicians.