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Though difficult to quantify, endometriosis is a relatively common condition, affecting roughly between 10-15% of women. It can have a variety of symptoms or may be insidious without any obvious signs. As regards fertility, it is estimated that around 30-40% of women with endometriosis do indeed have difficulties in conceiving. Although it has yet to be proven exactly how endometriosis can lead to low fertility, it is believed numerous factors come into play in this mechanism. Of course, at a more severe stage of the disease, anatomical factors impact on natural conception, such as symphysis around the fallopian tubes or large endometriotic cysts in the ovaries. Without having much information in your specific case, I can’t exclude the possibility of your fertility being affected by endometriosis. Despite that, there are solutions which can help. Endometriosis laparoscopic surgery can improve the chances of pregnancy both by natural conceiving and IVF. Also, with the modern assisted reproduction protocol we can further increase the success rate through individualized treatment. When you decide to have a child, it would be a good idea to consult a specialist reproductive gynaecologist for guidance on your attempt.

You shouldn’t get anxious as you’re at the beginning of your efforts and often being hasty doesn’t help matters. Try then to rid yourself as much as you can of any stress from your everyday life. In any case, 85% of couples who try to get pregnant manage in the first year of their efforts. As far as prenatal screening goes, it’s a little early for you to resort to taking a whole series of diagnostic tests, which might be expensive and unnecessary in your case. On the other hand, the annual checkup with your gynecologist is very important, especially when you are considering getting pregnant. I think that an ultrasound check of the uterus and ovaries together with a blood test, a mammography and a Pap smear test suffice for evaluating your reproductive health system. If after a year of trying you still haven’t reached your goal, then it would be advisable for you to consult a specialist at an assisted reproduction center.

It is true that a healthy vagina, and particularly a healthy uterus, play an important role in embryo implantation and in a successful IVF. The condition of the vagina can be assessed through a clinical test and secretion culture both from the vagina and the ectocervix (vaginal part of the cervix). This test should not though be done during the menstrual cycle as it lessens its reliability. On the other hand, an evaluation of the state of the uterus requires more specialised tests. Firstly, an ultrasound check will assess the texture and morphology of the uterus. Also, an endometrial culture can be done, except it must not derive from menstrual material. I would suggest that you do a biopsy at a specialised center a few days after the end of your period. Thus, should any microbes be found in the uterus, they can be dealt with.