Can You Get Pregnant With Pelvic Congestion Syndrome? Fertility, Embolisation and IVF

Can you get pregnant with pelvic congestion syndrome? For most women, yes. Pelvic congestion syndrome (PCS) is pain caused by widened, refluxing veins in the pelvis, and it has not been shown to stop pregnancy. In fact, it is most common in women who have already had children. Questions about pregnancy after treatment, egg reserve and IVF are harder to answer, because research is limited. This guide sets out what is known, what is uncertain, and when to get advice.

Does pelvic congestion syndrome affect fertility?

There is no good evidence that pelvic congestion syndrome causes infertility. The main risk factor for PCS is having been pregnant, often more than once, so many women with the condition have already conceived without trouble.

A few doctors have suggested that congested veins could affect the ovaries or womb in some women. One small study from China followed 12 women with PCS who had not been able to conceive and in whom no other cause was found. After embolisation, 8 of the 12 became pregnant. This is interesting, but with so few women and no comparison group, it cannot show that the veins caused the infertility or that treatment fixed it.

PCS can affect trying for a baby in a more practical way. Many women have pain during sex or a deep ache for hours afterwards, which can make regular sex difficult. That deserves attention in its own right; see pain during or after sex.

Other causes to rule out

If you are having trouble conceiving, it is important not to assume that PCS is the reason. Other conditions that can cause both pelvic pain and fertility problems include:

• Endometriosis, which often causes painful periods and deep pain during sex
• Pelvic inflammatory disease, a past infection that can damage the fallopian tubes
• PMOS (formerly PCOS), which affects ovulation
• Fibroids or adenomyosis, depending on their size and position

Our comparison of pelvic congestion and endometriosis explains how these differ. Fertility also depends on the male partner. Men can have a related vein problem, a varicocele, which is a common and treatable cause of reduced sperm quality; see varicocele and fertility.

What pregnancy does to pelvic veins

During pregnancy, the pelvic veins carry much more blood and can widen by up to about half. Hormones relax the vein walls, and the growing womb presses on veins higher up. After birth the veins do not always return to normal.

This means:

• PCS symptoms can get worse during a pregnancy, or start after one
• Varicose veins of the vulva and upper thighs are common in pregnancy; see vulval varicose veins in pregnancy
• Each pregnancy adds to the strain, so symptoms can come back even after successful treatment

Procedures to close pelvic veins are not done during pregnancy.

Treat now, or after having children?

There is no single right answer. Things to discuss with your specialist include:

• How severe your symptoms are. If pain is affecting daily life or sex, treating sooner may make sense.
• How many more children you hope to have. Some women prefer to wait until their family is complete, because a later pregnancy may bring symptoms back.
• Other options in the meantime. Self-care and simple pain relief can help some women. Many hormonal treatments for PCS also prevent pregnancy, so they may not suit you while you are trying to conceive.

Can you get pregnant after ovarian vein embolization?

Ovarian vein embolisation closes the faulty veins from the inside with coils, plugs or a sealing foam. Blood from the ovaries then drains through other, healthy veins. The ovaries and womb themselves are not treated.

Pregnancies after embolisation have been reported in several studies, but the numbers are small and long-term follow-up is limited. Practical points include:

• Timing. Many teams suggest waiting a few months after embolisation before trying to conceive. There is no strong evidence for an exact interval, so ask your own specialist.
• Pregnancy test first. A test is done before the procedure, because it uses X-rays and contrast dye.
• Radiation. The ovaries lie close to the veins being treated, so they cannot be fully shielded. Teams aim to keep the X-ray dose as low as possible. It is reasonable to ask about the expected dose and how it compares with other tests.
• Coils. The coils stay in place permanently. They are not known to cause problems in a later pregnancy, but tell your obstetrician that you have had the procedure.

Does ovarian vein embolization affect fertility or egg reserve?

This is an emerging question. Studies so far have not shown that embolisation harms periods or the ability to conceive. However, a 2025 study from Turkey looked at 81 women and measured anti-Müllerian hormone (AMH), a blood test used as a rough marker of how many eggs remain. AMH fell by roughly 10 to 14% on average over the year after embolisation.

AMH also falls naturally with age, and the authors thought the change was mostly in line with normal ageing. They did, however, say that falls in women under 30 should not be ignored. The study looked back at past records, came from one centre and had no comparison group. Larger studies are needed before anyone can say whether embolisation affects egg reserve.

If you are planning a pregnancy, especially if you are older or already know your egg reserve is low, ask your specialist about this before treatment. Some women choose to have an AMH test beforehand.

Pelvic congestion syndrome and IVF

There is very little research on PCS and IVF, so be cautious with any firm claims you read online.

What is known is that ovarian stimulation, the hormone injections used in IVF, raises oestrogen levels well above normal and enlarges the ovaries for a time. In theory this could make congested veins and the heavy ache worse during a treatment cycle. Whether it affects IVF success is not known.

Practical steps:

• Tell your fertility clinic about your diagnosis and any embolisation you have had
• If you are considering embolisation, ask your fertility and vein specialists to agree on the timing, so it does not clash with a treatment cycle or pregnancy
• Know the warning signs of ovarian hyperstimulation syndrome (OHSS), a separate risk of IVF: a swollen and painful tummy, feeling sick or vomiting, shortness of breath, faintness or passing little urine. Contact your clinic straight away if these occur

When to see a fertility specialist

General guidance is to see a doctor if you have not conceived after a year of regular unprotected sex. See a doctor sooner if you are 36 or over, have irregular or absent periods, or already know of a possible fertility problem, such as endometriosis or past pelvic infection.

If you have PCS, it can help to see a gynaecologist or fertility specialist and a vein specialist who are willing to talk to each other. A Singapore vascular surgeon’s PCS questions page also touches on fertility.

When to see a doctor

See a doctor if you have pelvic pain that has lasted for months, pain that makes sex difficult, or worries about your fertility. If you are pregnant and develop new pelvic pain or vulval veins, tell your midwife or obstetrician.

Get urgent medical help for sudden severe pelvic or abdominal pain, heavy vaginal bleeding, fainting, fever with pelvic pain, pain or bleeding in early pregnancy, a painful swollen leg, chest pain or sudden breathlessness. In Singapore, call 995 in an emergency.

This article is general information, not personal medical advice. Please speak to a doctor about your own symptoms. How we create our content.