In my virtual practice, I’ve worked with many women living with endometriosis and navigating their fertility journey. While it’s not without its challenges, Naturopathy and nutritional medicine provide holistic options to optimise fertility outcomes and improve your chances of IVF success, alongside conventional treatment.
Endometriosis is a complex chronic condition, and while research is ongoing; hormonal, genetic, immune, environmental and lifestyle factors are involved. Up to 50% of infertile women have been found to have endometriosis, and a 2024 review found 44% of unexplained infertility cases were attributed to undiagnosed endometriosis.
Whether you’re trying to conceive naturally or with IVF, we have options to maximise your outcomes. In my clinical experience, these are four key areas I have found to benefit most:
1. Calming Inflammation (the fire)
Endometriosis is an inflammatory condition, and when your body is unable to keep inflammation in check, fertility and egg quality are affected. Think of inflammation like ‘a fire’, and our goal is calming the flames.
Here’s where to start:
• Follow an Anti-Inflammatory diet: A Mediterranean-style diet—full of vegetables, legumes, fish, olive oil, and nuts—is ideal
• Supplements: Quality fish oil (they’re not all the same!), herbal medicines and Palmitoylethanolamide (also known as ‘PEA’)
• Stress management: Ongoing stress adds fuel to the fire. Chronic stress is an accelerant for inflammatory processes in the body.
2. Nourish & Optimise Egg Quality
Endometriosis can reduce both egg quality and egg count, but while egg number can’t be changed, lifestyle and environmental factors can improve egg quality. The eggs developing now are influenced by your current habits, with diet, blood sugar balance, and toxin exposure all affecting outcomes alongside age.
Here’s where we can start:
• Increase Antioxidant-rich foods: Berries, leafy greens, colourful vegetables, nuts and seeds. These foods help counter oxidative stress which occur as a result of endo, and protects the DNA of your eggs.
• Evidence-based supplements: Research supports using Co enzyme Q10, NAD+ (a Vitamin B3 derivative), Omega-3 fats, Vitamin D, and N-acetyl cysteine (NAC) to support egg health.
• Balanced blood sugar: Making sure your meals contain quality protein, fibre, and healthy fats, which helps stabilise blood sugar levels and support hormonal balance.
Your egg quality is a changeable factor within your control. Remember, if you’re trying to get pregnant with IVF, you need to start working on this well before your egg retrieval (minimum 90 days).
3. Gut health and the microbiome
Many women with endo experience untoward digestive symptoms, from loose stools to constipation, multiple food sensitivities and bloating (commonly referred to as endo belly). The research has shown potential links with disturbed gut microbiome in women with endometriosis. Your gut health and your immune system are intimately linked.
Here’s what we can do:
• Adequate dietary fibre: 20-30g is the recommended daily intake for women. Nourish your gut microbiome with prebiotic fibres from vegetables and fruits (especially onion, garlic, leek and artichoke) to encourage the growth of good gut bacteria.
• Track daily bowel symptoms: and refer for further testing. Rule out coaleic disease or gluten intolerance and consider gut microbiome testing.
• Diet diary: to identify individual food triggers
4. Support Hormonal Balance
Endometriosis lesions depend on oestrogen for growth, but this doesn’t always mean you have high levels — blood testing this hormone on day 2 of your cycle can confirm. In endometriosis, oestrogen and histamine can drive each other in a cycle, worsening symptoms. Histamine is a chemical in the body released after injury or allergic reaction.
The hormone progesterone helps by calming our mast cells (responsible for releasing histamine), and supporting its clearance. If histamine is a factor for you, you might notice allergic-like symptoms that vary throughout your cycle.
If oestrogen is high, we can:
• Improve oestrogen clearance via the liver and bowels. Oestrogen is processed via the liver first, and then requires adequate dietary fibre to remove it via the bowels.
• Optimise ovulation: which naturally promotes progesterone production (oestrogens natural ‘counter’ hormone)
• Reduce the body’s toxic load: say goodbye to plastics, and limit EDC’s (endocrine disrupting chemicals) in toiletries and personal care items as much as possible.
Gentle next steps
It’s important to remember that there is no “quick-fix” for endo, and surgery alone doesn’t address the whole picture. Optimising fertility with endo requires the support of a multi-modality health care team, and I am quietly confident that after working together to create a personalised plan, we can improve your fertility outcomes and overall quality of life. Book a free Fertility Clarity Call here and get started today.
Author:
Corinne Leach
The Gentle Naturopath
Please note: this blog does not replace medical advice, and you should always seek personalised care. The Gentle Naturopath is a collaborative naturopathic clinic and we work alongside medical professionals for the best patient care.
References
1. Pessoa de Farias Rodrigues, M., Lima Vilarino, F., de Souza Barbeiro Munhoz, A. et al. Clinical aspects and the quality of life among women with endometriosis and infertility: a cross-sectional study. BMC Women’s Health 20, 124 (2020). https://doi.org/10.1186/s12905-020-00987-7
2. Van Gestel, H., Bafort, C., Meuleman, C., Tomassetti, C., & Vanhie, A. (2024). The prevalence of endometriosis in unexplained infertility: a systematic review. Reproductive biomedicine online, 49(3), 103848. https://doi.org/10.1016/j.rbmo.2024.103848
