I have seen women with endometriosis and fibroids go through a lot of uncertainty around fertility, and it can feel really overwhelming. Stage 3 endometriosis and transmural fibroids can make things more challenging, but natural conception is still possible in some cases depending on the individual situation. It is not the same journey for everyone, and having the right evaluation can give a clearer picture.
One thing my journey taught me is that fertility is rarely as straightforward as a diagnosis on paper. When I was dealing with adenomyosis, I went down so many rabbit holes trying to predict what the future would look like, but every case really is different. Plenty of people with endometriosis do conceive naturally, while others need a bit more help. I wouldn't lose hope based on the diagnosis alone. I'd have a detailed discussion with a fertility specialist who can look at your specific situation rather than just the stage of your endometriosis. I know the uncertainty is the hardest part. 🙁
While yes, conception can occur naturally with the presence of transmural fibroids and endometriosis stage III, both can decrease fertility according to the size and severity of the issues. While the transmural fibroids can distort the uterine cavity, they may cause implantation difficulties if large enough; endometriosis stage III is commonly associated with adhesions, ovarian cysts, and inflammation that can affect ovulation and egg quality or egg and sperm transport.
Many women do have a successful pregnancy while having transmural fibroids and endometriosis stage III, but it may be difficult. After six to twelve months of unsuccessful attempts at conceiving naturally (sooner if you are older than 35), it would be good to see a specialist. The specialist would evaluate the need for treatment of fibroids and endometriosis prior to any other assisted reproduction method like intrauterine insemination (IUI) or in vitro fertilization (IVF).
From what I've experienced with endometriosis, I wouldn't lose hope based on the diagnosis alone. Fertility can vary so much from one person to another. Some women with advanced endometriosis and fibroids are able to conceive naturally, while others may need treatment. I'd focus more on what your scans and fertility evaluation show rather than the stage itself, because that usually gives a much clearer picture of your chances.
I remember going through something similar, and it was really confusing at first. With transmural fibroids and stage three endometriosis, I realized natural conception can be more challenging, but it’s not impossible. For me, it helped to understand that every body reacts differently, and monitoring cycles, managing symptoms, and staying patient were key parts of the journey.