If you have endometriosis and you’re thinking about your fertility, this is one of those conversations I really want you to hear.

In this episode, I sat down with Dr. Shirin Khanjani, Consultant Gynaecologist and accredited subspecialist in reproductive medicine and surgery, to properly unpack what’s actually going on when endometriosis and fertility collide.

This chat comes off the back of the government’s Renewed Women’s Health Strategy, which has once again highlighted just how many women are still being dismissed, delayed, or left without answers. And when it comes to endometriosis, the reality is still pretty shocking. On average, it takes seven to eight years to get a diagnosis.

So this episode is about what happens next. Once you finally have that diagnosis, what do you actually need to know?

We talk through everything, from how surgery can affect your egg reserve, to why IVF isn’t a one-size-fits-all approach for endometriosis patients, to the emotional weight of trying to navigate all of this at the same time.

What we cover in this episode

• Why endometriosis has been one of the biggest gaps in women’s health and how that is slowly starting to shift
• The many different ways endometriosis can show up, from period pain to IBS, fatigue, back pain and infertility
• Why diagnosis still takes years and what you can do to advocate for yourself
• What to ask for at GP level and how to push for proper investigations
• The nuance around surgery and when it can help fertility or potentially reduce egg reserve
• What happens to ovarian reserve when chocolate cysts are removed
• Why fertility preservation, like egg or embryo freezing, should be considered before surgery in some cases
• How endometriosis changes IVF protocols and why specialist care matters
• The impact of fluid-filled tubes on implantation and when surgery becomes necessary
• The emotional and psychological toll of managing endometriosis alongside fertility treatment
• Why continuity of care makes such a difference to outcomes
• Common misconceptions around natural conception with endometriosis
• Why waiting too long without investigation can cost valuable reproductive time
• The impact of endometriosis in the workplace and why awareness still matters

Why endometriosis and IVF is not one-size-fits-all

One of the biggest takeaways from this conversation is that standard IVF pathways don’t always apply if you have endometriosis.

Dr. Khanjani explains that specialist protocols often need to include:

• Managing oestrogen levels carefully during stimulation
• Navigating more complex egg collections due to scar tissue or cysts
• Using antibiotics during egg collection to reduce inflammation risk
• Supporting the body after collection to keep endometriosis under control

Her advice is simple but important. When you walk into a clinic, ask directly if they have specific protocols for endometriosis patients. If they don’t, that tells you something.

Misconceptions we really need to clear up

There are a few things Dr. Khanjani is very clear on:

• You can still fall pregnant naturally with endometriosis. The chances may be lower, but it’s not impossible
• Egg quality is not automatically worse. IVF outcomes can be comparable once eggs are retrieved
• Surgery is not always the first step. In some cases, it can delay treatment or reduce egg reserve
• Being told to “just keep trying” without investigation can waste valuable time
• There isn’t one perfect pathway. Everything needs to be individualised

About Dr. Shirin Khanjani

Dr. Shirin Khanjani is a Consultant Gynaecologist and accredited subspecialist in reproductive medicine and surgery.

She holds a PhD from Imperial College London and is an Honorary Associate Professor at University College London. In her NHS role at UCLH, she focuses on low ovarian reserve, recurrent implantation failure and endometriosis.

She is also a co-founder of Fitzrovia Fertility, a London clinic built around genuinely personalised, evidence-based care.

Find out more:

https://fitzroviafertility.co.uk

https://fitzroviafertility.co.uk/about-us

Why this conversation matters

I hear from so many of you who’ve been dismissed, misdiagnosed, or passed from one specialist to another for years.

By the time you get to a fertility clinic, you’re often already exhausted, anxious, and unsure who to trust.

This episode is about helping you feel more informed and more prepared. So when you walk into those conversations, you know what to ask and what to look out for.

This episode is for you if you are:

• Newly diagnosed and trying to understand what this means for your fertility
• Considering surgery and want to understand the impact on your egg reserve
• About to start IVF and unsure whether your clinic has the specialist knowledge needed
• Trying to conceive and being told to wait without investigation
• Supporting someone navigating all of the above

Support and resources

The Fertility Podcast is the official podcast for Fertility Action, a charity providing education, support and campaigning for fairer access to fertility treatment.

Fertility Action runs free drop-in support sessions twice a week. No sign-up needed.

This episode is sponsored by Wild Nutrition

Navigating supplements when you are trying to conceive can feel overwhelming.

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As a listener of The Fertility Podcast, you can get:

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Thank you, as always, for your ear holes. Until next time.