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Although endometriosis may cover very different clinical situations, we can provide the following rational information to women asking about their fertility status: (i) Age is the only relevant, reproducible factor for predicting a woman’s fertility. (ii) Infertility related to endometriosis may affect 20–30 % of women. (iii) After surgery for endometriosis, women who have never tried to conceive before should not be considered as infertile. For women who have undergone surgery for infertility-related endometriosis, a multidisciplinary assessment guided by the endometriosis fertility index (EFI) and other main fertility factors is recommended to individualize the management. (iv) Surgery for endometriosis provides a good opportunity for an overall discussion on the different factors of infertility, keeping in mind the lack of a robust model capable of predicting spontaneous conception. (v) If previous surgery has not been carried out, attempting to conceive naturally should be the approach favored as much as possible during the next 6–12 months. (vi) Women with endometriosis and a risk of altered ovarian function should consider egg freezing to preserve any subsequent fertility project. (vii) An assessment of pain and other fertility parameters may be offered in a multidisciplinary reference center that has the full range of available therapeutic options (surgery, assisted reproductive technology, medical and gynecological support for pain and fertility preservation).