I'm starting to think I have endometriosis. Do I need surgery?

Yes and no. The cause of endometriosis is unknown. The model describing endometrial implants is an unproven theory. Once the diagnosis has been made, invasive treatments are often undertaken based on speculation and this model. Invasive treatments can evoke fertilization-impeding adhesions. Women with endometriosis have dysparunia, which might limit sexual activity and potential fertilization events.