The long-term impact of endometriosis on reproductive outcomes.

Endometriosis is a condition where tissue similar to the lining of the uterus grows outside the womb, causing pain and, in many cases, difficulties getting pregnant. Surgery to remove endometriosis can relieve symptoms, but the evidence for whether it also improves fertility — particularly for moderate to severe disease — is limited. This study follows women with moderate or severe endometriosis over time to understand the impact of surgical treatment on their chances of pregnancy and live birth. You may be eligible if you are under 38 years old, want to have children now or in the future, and have been diagnosed with moderate or severe endometriosis on laparoscopy or imaging (ultrasound or MRI). You will need to own and use a mobile phone. Participants will be tracked over several years and asked about their fertility outcomes — whether they became pregnant naturally, through IVF, or not at all. This is an observational study, meaning the researchers will not tell you which treatment to have; they simply follow what happens. The data will help clarify whether operating on endometriosis before attempting pregnancy is genuinely beneficial, helping women and their doctors make better-informed decisions.