Aim: This study aims to investigate the impact of endometriosis on female fertility and explore innovative treatments and interventions to mitigate its adverse effects. Background: Endometriosis is a common gynecological condition characterized by the presence of endometrial tissue outside the uterus, affecting millions of women worldwide. It has been associated with significant challenges in achieving and maintaining pregnancy due to various mechanisms, including the distortion of pelvic anatomy, inflammation, and hormonal disruptions. While the link between endometriosis and infertility is well-established, innovative approaches for fertility preservation and enhancement are continually evolving, offering hope to affected individuals. Methods: This research involves a comprehensive literature review, analysis of clinical data, and investigation into cutting-edge therapeutic modalities aimed at addressing endometriosis-related fertility issues. We assess the efficacy and safety of existing treatments, including medical management, surgical interventions, and assisted reproductive technologies. Furthermore, we explore emerging strategies such as immunomodulation, regenerative medicine, and personalized treatment plans tailored to the individual's unique disease profile. Results: Our findings reveal the multifaceted impact of endometriosis on female fertility, confirming its association with reduced ovarian reserve, tubal dysfunction, and altered uterine receptivity. We also identify promising outcomes from innovative treatments, including immune-based therapies, tissue engineering, and targeted pharmacological interventions. These advancements show potential in improving pregnancy rates and the overall reproductive health of women with endometriosis. Conclusion: Endometriosis exerts a substantial influence on female fertility, necessitating a comprehensive and multidisciplinary approach to management. Innovative treatments and interventions offer new avenues for improving fertility outcomes and enhancing the quality of life for individuals affected by this condition. A personalized, patient-centered approach that combines traditional and emerging therapies holds promise in addressing the complex interplay between endometriosis and infertility.