Endometriosis can impair fertility through several mechanisms. It may cause adhesions and blockages in the reproductive organs, particularly the fallopian tubes, thereby preventing the egg from reaching the uterus. The formation of endometriomas (chocolate cysts) in the ovaries can hinder healthy ovulation and diminish ovarian reserve, further reducing the chances of conception. Furthermore, inflammatory cytokines and humoral factors released from endometriotic lesions can adversely affect embryo development and implantation. Following appropriate treatment, there is a reported 40% increase in pregnancy rates within two years. If natural conception remains unsuccessful, assisted reproductive technologies such as in vitro fertilization (IVF) may be considered.