Endometriosis can be a significant cause of infertility in women struggling to conceive. In some cases, scar tissue (adhesions) caused by endometriosis can lead to blockages in the fallopian tubes, preventing pregnancy. However, in most women, the exact mechanisms by which endometriosis affects fertility are not yet fully understood.

Mechanisms by which endometriosis may contribute to infertility include:
Reduced ovarian reserve: It can decrease the number of eggs in the ovaries (ovarian reserve).
Ovulatory dysfunction: It can disrupt regular ovulation.
Fallopian tube obstruction: It can cause blockages in the tubes, preventing the union of sperm and egg.
Toxin production: It may lead to the production of natural toxins that can adversely affect sperm or harm the embryo.
Implantation failure: It can prevent the embryo from implanting in the uterine wall.
Negative impact on embryo development: It can impair the healthy development of the embryo.