Does Pelvic Congestion Syndrome Affect Fertility?

If you’re managing chronic pelvic pain while also trying to conceive, here’s what’s understood about pelvic congestion syndrome and fertility.

For women dealing with pelvic congestion syndrome (PCS) who are also thinking about pregnancy, a common and understandable concern is whether the condition — or its treatment — could affect their ability to conceive. Here’s an honest look at what’s known.

PCS Itself Is Not Understood to Cause Infertility

Pelvic congestion syndrome is a vascular condition — it involves faulty vein valves allowing blood to pool in the pelvis rather than draining efficiently. It does not affect the ovaries, uterus, or fallopian tubes directly, and it is not considered a recognized cause of infertility in the way conditions like endometriosis or blocked fallopian tubes are. That said, living with chronic pain of any kind can affect quality of life, intimacy, and overall wellbeing during a time when a woman may already be managing the stress of trying to conceive.

The Pregnancy Connection Runs the Other Way

Interestingly, the relationship between PCS and pregnancy tends to run in the opposite direction: multiple pregnancies are a significant risk factor for developing PCS in the first place. Pregnancy increases blood volume and puts sustained pressure on the pelvic veins, which can weaken the valves over time — part of why PCS is more commonly diagnosed in women who have been pregnant multiple times.

Does Treatment Affect Fertility?

Gonadal vein embolization, the standard treatment for PCS, does not affect the ovaries, uterus, or menstrual cycle, and it is not understood to impact fertility. The procedure specifically targets the malfunctioning veins responsible for the pain, without touching the reproductive organs themselves.

What About Future Pregnancies After Treatment?

Because pregnancy is a known risk factor for PCS, some women reasonably ask whether treating PCS now could affect — or be affected by — a future pregnancy. While every case should be discussed individually with your care team, treating the current episode of PCS does not prevent future pregnancies, and there’s no inherent reason a future pregnancy couldn’t happen after treatment. It is worth knowing that a subsequent pregnancy could theoretically place similar pressure on the pelvic venous system again, which is a conversation worth having with your provider based on your specific situation.

What This Means for You

If you’re managing PCS and also planning for pregnancy, the most useful step is a direct conversation with your care team about your specific timeline and goals, rather than assuming either the condition or its treatment poses a fertility risk on its own.

Learn more on our Pelvic Congestion Syndrome page, or read about how gonadal vein embolization works.