What to do?

[NorthernBelle79]

Hi Ladies, looking for a little bit of advice. I was diagnosed with Endometriosis in 2006 (in Australia while travelling - had to pay to go to a private clinic after being told in 2005 following a laparoscopy in UK that there was nothing wrong with me!). I have been pregnant on 2 occasions. I suffered a miscarriage at 26 and another at 28 (ectopic pregnancy, natural miscarriage, no surgery required). This was in a previous relationship. My symptoms in my late twenties/ early thirties have been a lot milder than when I was younger and following my second laparoscopy and diagnosis I remained on oral contraceptive (Microgynon 30). In December 2012 I got engaged and I am getting married this December. Given my age (33) and my gynaelogical history we want to start trying to conceive immediately. I stopped taking my oral contraceptive in February in order to ensure that it is completely out of my system when we get married. My periods are 'regular' in that I have had one every month since I have stopped the pill. However, my main concern is the length of my period. At present, I have been spotting for the last 9 days, a combination of red and brown blood, but only today am I experiencing some cramping (mild) and full flow of blood (day 10). Because of this I am finding it very difficult to identify the first day of my cycle accurately. I have decided to start tracking my basal body temperature as a way of possibly identifying when I ovulate. I have never been under the care of a gynaecologist in the UK and just find that I am starting to worry more and more about my ability to conceive and reach full term pregnancy. I have an appt with my GP next week but just feel that I will be told to come back after we have been trying for 6 months. I am desperate to become a mother and just don't know where I go from here?? :((

[Impatient]

You could ask for a dye check through the tubes to see if they are clear and there is room for the released egg to make it to the uterus. Having had an ectopic it is pretty high risk that you could have scar tissue blocking one of the fallopian tubes but the other ought to be functioning okay. For that reason alone you must be patient and give it more time.

If the possibility of only one ovary and tube are working then you need to have ovulated from that side to be in with a chance of a natural pregnancy. Which should be every other month on average.

Having the dye test, should it show both are blocked, would indicate the need for IVF. If from the early lap op there wasn't anything significant showing up to be endo, the odds are pretty much in your favour that one side at least is working normally.

Waiting 6 months or a year is not unreasonable given the situation. Many women wait and continue trying for much longer than that, and hey presto they end up conceiving.

Others try for a long time then seek help. 6 months is nothing. That's just 3 ovulations from one ovary. The average for any healthy woman is 4 months to fall pregnant, so double that to 8 months on average if you only have 1 clear tube and ovary working.

The worst thing to do is to stress about it. Periods can take time to settle back after being on the pill for a long time, and there are drugs to take to stop the lengthy bleeds after a few days (Tranexamic Acid is a blood clotter often used for this purpose.) Ask your GP for a clotting drug, so you do have a better idea of when your cycle starts and can work out roughly the ovulation date from there.

A lot of women with endo do feel when ovulation happens as a sharp pop pain from one ovary or the other or both (twins) and you should be keeping note of any tweeks of pain around that time as it could be ovulation time. It is a bit like a musle stitch after you have over done the exercises. You might not be aware of it or noticed it yet, but it is worth listening to all the twinges that your body makes mid cycle.

[Cloudyrain]

Agree with Impatient - the average time for a couple to concieve (with no problems or complications) is 12 to 18 months, although a lot pf GPs will start the initial tests needed for referrsl after 12 months.

Have a look at Taking Charge Of Your Fertility website (the book is also really good) and look up cervix monitoring - it's a really good way of identifying fertile times, and is good for women with irregular cycles or lots of spotting.

Make sure you are both taking some good vits and being generally healthy, and where possible try have have sex every other day.

I know it's worrying, but try and take comfort that your previous experiences were with a different partner and also separate problems.

Good luck x

[NorthernBelle79]

Thank you for your replies! I think I'm more concerned with the changes to my cycle and my periods more than anything, and if this indicates that my endo has got worse. After my last miscarriage (ectopic) I was told by the consultant I was under that I was to be referred immediately back to his care once I started trying to conceive again and not to wait 6 months (which for my hospital is the normal waiting period for those with existing gynecological conditions), so I'm hoping that this is shown on my medical records. I would like to know if both of my tubes are clear so I'll discuss this with my GP at my appt next week.