by AFN member Rachel Sheriff
What Is Endometriosis and Why Does It Affect Fertility?
Endometriosis is a condition in which tissue similar to the uterine lining grows outside the uterus on the ovaries, fallopian tubes, bowel, or elsewhere in the pelvis. It affects roughly one in ten women of reproductive age in the UK and is one of the most common causes of fertility difficulties. Many women with endometriosis are referred directly to IVF following diagnosis but this is not always the only path forward, and it is rarely the conversation that gets had first.
Does Endometriosis Always Mean IVF?
No. Endometriosis does not automatically mean IVF is the only or the best next step. While some women with endometriosis will need assisted conception, many can conceive naturally or with targeted support particularly when the systemic and inflammatory factors driving the condition are properly identified and addressed. The difficulty is that endometriosis tends to be treated as a single diagnosis, when in practice it is a highly variable condition that presents very differently from one woman to the next.
Why Endometriosis Looks Different in Every Woman
Two women can have the same endometriosis diagnosis and present almost nothing alike. One might have severe pain, heavy bleeding, a history of clotting, and cold extremities. Another might have minimal symptoms, a late diagnosis, and a string of failed cycles with no clear explanation. Symptom severity does not reliably predict fertility impact, which is one of the reasons a standard treatment pathway can miss important detail.
Chinese medicine works from the principle that the pattern matters as much as the label. Within an endometriosis diagnosis, we commonly see blood stasis, often combined with cold, Kidney deficiency, Liver Qi stagnation, or Damp-Heat, depending on how the condition is presenting. Each combination calls for a different approach, and identifying it correctly is central to how we treat.
What We Look at in Endometriosis Alongside Acupuncture Treatment
At The Fertility Suite, we build a thorough picture of each patient’s presentation before beginning treatment. Alongside the Chinese medicine diagnostic process, there are several clinical factors we consider particularly relevant in endometriosis:
Blood stasis
This is the core TCM pattern in almost every endometriosis presentation we see. Blood stasis contributes to pain, poor uterine lining quality, adhesions, and difficulties with implantation. The severity and combination with other patterns varies considerably between patients, which is why treatment is always individualised rather than protocol-driven.
Chronic inflammation
Endometriosis is both driven by and perpetuates chronic systemic inflammation. This has a direct impact on egg quality, the peritoneal environment, and uterine receptivity. Addressing inflammation is not a peripheral concern in endometriosis and fertility, it is central to it.
Microbiome dysbiosis
Research increasingly links endometriosis with disruption to both the gut and reproductive microbiome. Women with endometriosis show higher rates of microbiome imbalance, which affects oestrogen metabolism, immune regulation, and the uterine environment. This is rarely discussed in a standard gynaecology appointment but is clinically significant when trying to conceive.
Low testosterone
Often overlooked in women, testosterone is relevant to energy, libido, and ovarian response. Low testosterone is more common in women with endometriosis than is generally recognised, and it is worth investigating as part of a broader hormonal picture, particularly where there is a history of low response in IVF cycles.
Cold and obstruction patterns
Not present in every endometriosis patient, but when they are, they matter. Cold in the uterus is a recognised TCM pattern that affects uterine receptivity and blood flow to the endometrium. In patients where this pattern is present, addressing it is a clinical priority before conception is attempted.
Can Acupuncture Help Endometriosis and Fertility?
There is a growing body of research supporting the use of acupuncture in endometriosis management, particularly in relation to pain reduction, inflammation, and pelvic blood flow. Acupuncture is thought to modulate the immune response, reduce prostaglandin activity, and improve circulation to the uterus and ovaries. At The Fertility Suite, fertility acupuncture is used as part of a structured, individualised treatment plan that addresses the specific pattern driving each patient’s presentation, not as a one-size approach to a diagnosis that is anything but uniform.
When Should Someone With Endometriosis Consider Fertility Acupuncture?
As early as possible in the fertility journey and ideally before any assisted conception decision is made. Women who begin treatment with a meaningful lead time frequently see improvements in cycle quality, pain levels, and the inflammatory markers that matter for conception. Acupuncture is also used effectively alongside IVF when that route is needed, to support uterine receptivity and response to stimulation.
How The Fertility Suite Approaches Endometriosis and Fertility
We are a specialist fertility acupuncture clinic with six UK locations: Oxted, Tunbridge Wells, Horley, Central London, Salisbury, and the Scottish Borders. Our practitioners hold postgraduate qualifications in fertility acupuncture and work within an evidence-informed framework that brings Chinese medicine diagnostics alongside a thorough understanding of reproductive medicine.
Endometriosis is one of the conditions where there is a great deal that can be investigated and addressed either before IVF is on the table, or running alongside it. The diagnosis tells you what is present. Chinese medicine helps to explain why, and what might shift if it is treated properly.
Download Our Free Guide to Endometriosis and Fertility
If you have endometriosis and you are trying to conceive, our free guide covers what we look at clinically, which investigations are worth requesting, and what your options actually are beyond the standard referral pathway. You can find this on our website under ‘resources’
About The Fertility Suite
The Fertility Suite is a specialist fertility acupuncture clinic founded by Rachel Sherriff BSc (Hons) Acupuncture, Dip. Fertility Acupuncture, MAAC. With nine years of clinical experience and six UK clinic locations, The Fertility Suite supports women navigating fertility challenges through evidence-informed Chinese medicine practice.