Endometriosis can cause painful periods, pelvic pain, heavy or irregular bleeding, pain during sex, digestive symptoms, and difficulty getting pregnant. For some patients, symptoms are severe and disruptive. For others, endometriosis is only discovered during a fertility evaluation or after months or years of unexplained infertility. At Kofinas Fertility Group, our endometriosis specialists evaluate how…
Endometriosis can cause painful periods, pelvic pain, heavy or irregular bleeding, pain during sex, digestive symptoms, and difficulty getting pregnant. For some patients, symptoms are severe and disruptive. For others, endometriosis is only discovered during a fertility evaluation or after months or years of unexplained infertility.
At Kofinas Fertility Group, our endometriosis specialists evaluate how endometriosis may be affecting your pain, reproductive health, and ability to conceive. We offer advanced endometriosis treatment options, including minimally invasive surgery when appropriate, and help patients understand whether medication, laparoscopy, fertility treatment, or a combination of approaches is best for their goals.
If you have been diagnosed with endometriosis, suspect you may have it, or are looking for a fertility clinic in NYC, Brooklyn, Long Island, or Staten Island for pelvic pain or infertility, our experienced team of doctors can help you understand your options and create a treatment plan focused on your health, comfort, and future fertility.
Endometriosis is a reproductive health condition where tissue similar to the lining of the uterus grows outside the uterus. This tissue may be found on or near the ovaries, fallopian tubes, pelvic wall, bowel, bladder, or other areas of the pelvis.
Like the uterine lining, endometriosis tissue can respond to hormonal changes during the menstrual cycle. However, because this tissue is outside the uterus, it cannot leave the body the way menstrual blood does. Over time, this can lead to inflammation, scar tissue, adhesions, cysts, pelvic pain, and fertility problems.
Endometriosis can be difficult to diagnose because symptoms vary widely and may overlap with other conditions, including ovarian cysts, irritable bowel syndrome, pelvic inflammatory disease, PMOS, and other causes of pelvic pain or infertility.
Some patients have severe pain with minimal visible disease. Others have advanced endometriosis with few symptoms. This is why a careful evaluation by an endometriosis doctor or fertility specialist can be important, especially if you are trying to conceive.
Endometriosis symptoms can range from mild to severe. Some patients have symptoms every month, while others experience pain or discomfort only during certain parts of the menstrual cycle.
Common symptoms may include:
Endometriosis pain treatment may involve medication, hormonal therapy, surgery, fertility treatment, or a combination of approaches. The right plan depends on your symptoms, diagnosis, fertility goals, and whether endometriosis is affecting your reproductive organs.
You may benefit from an endometriosis consultation if you have ongoing pelvic pain, painful periods, unexplained infertility, ovarian cysts, pain during sex, or symptoms that have not improved with standard treatment.
You should also consider seeing an endometriosis specialist if:
At Kofinas Fertility Group, our team evaluates endometriosis through the lens of both symptom relief and reproductive health. This helps us recommend treatment options that support your immediate needs and your long-term family-building goals. Patients reach our fertility specialists from across NYC, Brooklyn, Long Island, and Staten Island.
Endometriosis is one of the most common conditions associated with infertility. It can affect fertility in several ways, depending on where the tissue is located and how advanced the disease is.
Endometriosis may affect fertility by:
Some patients with endometriosis are able to conceive naturally. Others may need endometriosis fertility treatment, such as surgery, IUI, IVF, or a combination of care.
A fertility specialist for endometriosis can help determine whether your symptoms, imaging, ovarian reserve, fallopian tubes, or prior fertility history suggest that treatment is needed before moving forward with pregnancy attempts or fertility treatment. Learn more about fertility testing and diagnosis.
Endometriosis is often classified in stages based on the amount, depth, and location of endometriosis tissue, as well as the presence of scar tissue or ovarian cysts.
The stages include:
The stage of endometriosis does not always match the severity of symptoms. A patient with stage 1 endometriosis may have significant pain, while a patient with stage 4 endometriosis may have fewer symptoms but more fertility-related complications.
For patients with severe endometriosis or stage 4 endometriosis, treatment planning should consider pain, pelvic anatomy, ovarian reserve, fallopian tube function, surgical risks, and fertility goals.
Severe endometriosis may require a more specialized treatment approach, particularly when scar tissue, ovarian endometriomas, fallopian tube damage, or deep infiltrating endometriosis are present.
Stage 4 endometriosis treatment may involve:
For patients who want to conceive, the goal is not only to treat endometriosis, but also to protect reproductive potential. This may require close coordination between surgical care and fertility treatment.
Deep infiltrating endometriosis occurs when endometriosis tissue grows deeper into pelvic structures. It may involve areas near the bowel, bladder, uterosacral ligaments, rectovaginal space, or other pelvic tissues.
Symptoms may include:
Deep infiltrating endometriosis treatment can be complex. Some cases may require advanced laparoscopic surgery and coordination with other specialists, especially if the bowel or bladder is involved.
If deep infiltrating endometriosis is suspected, your doctor may recommend imaging, surgical evaluation, fertility testing, or referral to the appropriate surgical specialist as part of your treatment plan.
Endometriosis can sometimes involve or irritate areas near the bowel, leading to digestive symptoms that may be mistaken for gastrointestinal conditions.
Possible symptoms of bowel endometriosis may include:
A bowel endometriosis specialist or experienced pelvic surgeon may be needed when endometriosis is suspected to involve the bowel. If fertility is also a concern, your care plan should account for both surgical management and reproductive goals.
Patients with bowel symptoms should receive an individualized evaluation to determine whether endometriosis, another gastrointestinal condition, or both may be contributing to their symptoms.
An ovarian endometrioma is a cyst caused by endometriosis. These cysts are sometimes called “chocolate cysts” because they contain old blood.
Ovarian endometriomas may affect fertility by interfering with ovarian function, egg release, or response to fertility treatment. They may also be associated with pelvic pain, inflammation, and more advanced endometriosis.
Ovarian endometrioma treatment depends on several factors, including:
Surgery may be recommended in some cases, but not every endometrioma needs to be removed immediately. Because surgery on the ovary can affect ovarian reserve, treatment decisions should be made carefully, especially for patients who want to preserve fertility.
There is no single treatment plan that is right for every patient with endometriosis. The best endometriosis treatment depends on your symptoms, disease severity, age, fertility goals, prior treatments, and whether you are actively trying to conceive.
Treatment options may include:
Some treatments focus on symptom control. Others aim to remove endometriosis tissue, restore pelvic anatomy, improve fertility, or support pregnancy.
For patients who want to become pregnant, it is important to choose treatment options that align with fertility goals. Some medications used to control endometriosis symptoms temporarily prevent ovulation or pregnancy, while surgery and fertility treatment may be better suited for patients actively trying to conceive.
Endometriosis pain can be debilitating. Some patients experience pain only during menstruation, while others have chronic pelvic pain throughout the month.
Endometriosis pain treatment may include:
Medication may help manage symptoms, but it does not always treat the underlying endometriosis tissue. If pain continues despite medication, or if fertility is a concern, minimally invasive endometriosis surgery may be considered.
Minimally invasive endometriosis surgery is often performed using laparoscopy. During laparoscopic surgery, small incisions are made, and a thin camera is used to view the pelvis. Surgical instruments can then be used to remove or treat endometriosis tissue, scar tissue, adhesions, or ovarian cysts.
Laparoscopic surgery for endometriosis may help:
Compared with open surgery, minimally invasive surgery generally uses smaller incisions and may allow for a shorter recovery time.
Not every patient with endometriosis needs surgery. However, surgery may be recommended when pain is severe, symptoms do not improve with medication, imaging suggests endometriosis or endometriomas, or fertility may be affected. Learn more about our surgical program.
Excision surgery for endometriosis involves surgically removing endometriosis lesions from the affected tissue. This is different from approaches that burn or destroy surface tissue without removing the entire lesion.
Excision may be considered when endometriosis is causing pain, scarring, adhesions, ovarian cysts, or fertility-related problems. The goal is to remove visible disease while protecting healthy reproductive tissue whenever possible.
For patients with fertility goals, the surgical plan should be especially careful. Removing endometriosis may help improve the pelvic environment, but surgery involving the ovaries, fallopian tubes, or deep pelvic structures should be planned with reproductive outcomes in mind.
Endometriosis fertility treatment may include surgery, fertility medication, IUI, IVF, or a combination of care. The right approach depends on your age, ovarian reserve, fallopian tube status, partner factors, prior pregnancy history, and severity of endometriosis.
For some patients, laparoscopic surgery may improve fertility by removing endometriosis lesions, scar tissue, adhesions, or endometriomas. For others, IVF may be recommended, particularly if the fallopian tubes are blocked, ovarian reserve is reduced, or pregnancy has not occurred after other treatments.
A fertility specialist for endometriosis can help answer important questions, including:
At Kofinas Fertility Group, treatment planning is personalized around both endometriosis and your family-building goals. Learn more about in vitro fertilization and IUI and ovarian stimulation therapy.
Not every patient with endometriosis needs surgery. Some patients can manage symptoms with medication, hormonal therapy, or monitoring. However, surgery may be recommended when symptoms are severe, fertility is affected, or a diagnosis needs to be confirmed.
You may be a candidate for laparoscopic surgery for endometriosis if:
The decision to have surgery should be made with an experienced endometriosis doctor who understands your symptoms, diagnosis, and fertility goals.
A hysterectomy is the surgical removal of the uterus. It may reduce symptoms for some patients with severe endometriosis, but it also eliminates the ability to carry a pregnancy.
Kofinas Fertility Group does not perform hysterectomy for endometriosis. Our focus is on treatment that preserves the uterus and protects your reproductive options, including medication, laparoscopy, and excision surgery. If you have been told you may need a hysterectomy for endometriosis, a consultation can help you understand whether a uterus-preserving treatment approach may be appropriate for your situation.
Kofinas Fertility Group provides endometriosis evaluation and treatment planning with a strong focus on fertility and reproductive outcomes. Patients see our fertility and surgical specialists at locations across NYC, Brooklyn, Long Island, and Staten Island.
Our team may evaluate:
For patients with endometriosis and infertility, treatment should not be one-size-fits-all. Some patients benefit from surgery before fertility treatment. Others may be better served by moving directly to IVF. Some need both.
Our goal is to help patients understand their diagnosis, reduce symptoms when possible, and choose the treatment path that best supports their ability to build a family. You can view all of our locations to find the office most convenient for you.
If you have pelvic pain, painful periods, ovarian endometriomas, suspected endometriosis, or difficulty getting pregnant, Kofinas Fertility Group can help you understand your options.
Our endometriosis specialists provide evaluation and treatment planning for patients with mild, moderate, severe, and complex endometriosis, including patients seeking pain and symptom relief as well as those with fertility goals.
Request an appointment today to speak with an endometriosis doctor and learn whether treatment, surgery, or fertility care may be right for you.
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