1. I was diagnosed through laparoscopy a few years ago. My doctor said that is the only formal way to be diagnosed. I had HORRIBLE/ PAINFUL periods before my surgery. Same as a PP, vomiting, blacking out, etc. However, my doctor said some women can have endo without these symptoms. The level of pain varies person to person depending on the level of endo you have.
2. No, it does not mean your dream is immediately gone. For me personally, my doctor said my endo had not affected my tubes at that point, so everything should be fully functional for me. However, some women have unexplained infertility, so no one ever knows until it happens. My doctor said he would only want me to TTC for 6 months before he would like me to come in for another laparoscopy procedure. I would like to add, I have very regular periods (though painful) which my doctor said will be helpful when we start TTC.
3. Sorry, me and DH have not started TTC yet. However, my friend has endo too, and she conceived her first child with zero issues, and then took years of TTC for baby #2.
4. Once again, every women is different. The tissue can grow anywhere, so you wont know how it specifically will affect you until you have a procedure. For me, all of my endo is oddly placed above my uterus, so my doctor is very hopful on my TTC in the future. He did say endo can penetrate your tubes, and then he would be very concerned.
(Also, I stopped taking BC years ago because I found it didnt affect my pain, but again, everyone is different. After my procedure, I had significantly less pain than before)
All of that being said, you NEVER know what your future holds until it happens. My SIL is the perfect example of health and exercise and couldnt conceive naturally, all unexplained, there is literally nothing medically wrong with her.