Endometriosis is a very interesting condition in that there are many features of it that are not understood. It does appear that the presence of endometriosis can affect egg quality but in a manner that is not understood. It appears that women with endometriosis do not get pregnant as easily even with the assistance of in vitro fertilization as easily as women without endometriosis. The reason for this is likely very complex but there appears to be an effect of the endometriosis on how easily the potential eggs in the ovary are stimulated, a negative effect on the quality of the eggs itself and a negative effect on the lining of the uterus where the egg intends to implant. Interestingly, removing endometriomas prior to in vitro fertilization does not appear to improve outcomes suggesting that some of these other negative features may be playing a role too.