Endometriosis is a chronic and often painful condition where tissue similar to the uterine lining grows outside the uterus, affecting an estimated 10% of reproductive-age women globally, or about 190 million individuals. In India, approximately 26-42 million women are affected. The article from Hackensack Meridian Health accurately addresses the critical question of whether endometriosis puts fertility at risk, confirming that it indeed can. Research indicates that between 30% and 50% of women with endometriosis experience infertility. The mechanisms by which endometriosis impacts fertility are multifaceted. These include the formation of scar tissue (adhesions) that can distort pelvic anatomy and block fallopian tubes, inflammation caused by lesions releasing harmful chemicals, reduced egg quality due to ovarian cysts (endometriomas), and impaired embryo implantation linked to changes in the uterine lining. Despite these challenges, many individuals with endometriosis can still conceive naturally or with the help of fertility specialists. Symptoms of endometriosis vary but commonly include severe pain during menstruation, chronic pelvic pain, heavy menstrual bleeding, painful intercourse, and discomfort during bowel movements or urination, along with fatigue. Diagnosis is frequently delayed, with an average time of 4 to 12 years from symptom onset to definitive diagnosis, which typically requires a laparoscopic procedure and tissue biopsy. There is currently no known cure for endometriosis; however, symptoms can be effectively managed through medications like painkillers and hormone therapy, or surgical interventions such as excision or ablation of endometrial tissue. These treatments aim to control pain, limit disease progression, and preserve or restore fertility where possible. Hackensack Meridian Health is a highly reputable healthcare system, lending strong credibility to the information presented.