Had op today-queries..GnRH,Kissing ovaries,obliterated POD??

Am back from op and all went ok despite my nerves! Pain free and not too bloated. Have a bit of shoulder discomfort but mainly just very very tired!

Diagnosed severe endo with removal of large cyst and a smaller one drained and lasered. Ovaries were kissing (does this affect fertility) and obliterated POD(no idea what this is-help?) tubes were clear though and removed lots of patches.

She wants me to consider 6 months of GnRH injections...any body any experiences? She said it will bring on menopause type symptoms but reduce the endo down further before then trying for a baby. Or alternatively take contraception for a period.

I'm so completely overwhelmed but glad there's an answer. I've been referred to a specialist but I'm terrified of what to do next. I so desperately want a baby so do I wait 6 months and continue treatment or just crack on I'm not sure especially as she was unable to say if it would greatly improve chances! Will seek further advice but some help would be greatly appreciated. Luckily the pain each month is actually ok and lessened since some weight loss so I'm not seeking treatment for that as such just TTC.

4 Replies

  • Ovaries kissing is stuck together with adhesions which get cut and the ovaries will have been stuck back where they are supposed to be, so yes while kissing it does mean released eggs not likely to reach fallopian tubes but now they ar back where they are supposed to be should solve that one.

    Obliterated POD... that's a biggy. The pouch of dougls or POD for short, is the gap behind the uterus and in front of the bowel. It is the lowest space in the abdomen and unfortunately due to gravity, that's usually where the bleeding from all your endo will end up falling in to ..in the past. This is rectovaginal or RV endo and once in there with no escape route, it forms a mass of sticky old blood and endo cells which can mean that endo is growing on the outside surfaces of the vagina, cervix and the bowel, basically around the POD.

    Once the POD is filled up the adhesions from endo growth and irritation grows to the extent it covers over the POD sealing the old blood in there and gluing the uterus to the bowel. This lump or mass of old blood can dent in to the bowel and the vagina causing sex pain and pooping pain and difficulty.

    If this was not removed in this surgery then it is probably something that does need seeing to by an expert endo surgeon - this is one of the most complex of the endo surgeries, not normally one to be attempted by a standard gynaecologist.

    It's up to you whether you want this done before trying for a pregnancy or waiting till after if they haven'tyet tackled it.

    On the plus side, having the ovaries back where they are meant to be and cleaned up, along with clear tubes does mean you are unlikely to need IVF and a natural conception is much more likely than it had been before the op.

    The Menopause drugs - GnRH drugs (zoladex, Prostap Lupron, Decapeptyl etc) are all chemo hormone drugs highly toxic to a pregnancy and render hormone contraceptives useless.

    If you don't need the drugs and having a diagnosis and surgery means you shouldn't need them now, then avoid them like the plague.

    It is a huge commitment to be on them and they come with very high risk of ghastly side effects and a long pause from trying for a baby.

    Each dose (even if you only have 1 and stop) will remain in the body for 4 months while you must avoid falling pregnant. If you do opt for it - and last 6 months which many don't last, then add 4 months to the end of that before it is safe for baby making. It would be close on a year delay to starting a family and add to that the unpleasant side effects. Not worth it at all, considering where you want to go next.

    I would absolutely advise you to stick with birth control pills to manage your period for a while as you recover from this surgery, research your options about whether another surgery if needed, is better done before the baby making or whether you are better to get cracking on that first.

    Do not allow any nurse near you to give you a GnRH drug. I had the misfortune to have a nurse come up to me in hosp and implant zoladex in my stomach without telling me what it was, what it was called what it would do. I had not discussed it with anyone, hadn't a clue what it was and there i was started on zoladex in hospital as I was coming round from anaesthetic. Some GnRH are injected in the bum or thigh.

    Do NOT under any circumstance start the menopause drugs without doing a full and thorough homework on them. you can start them when you are ready, but these are super powerful with many hazards to taking them and I would never ever recommend anyone start them without being fully aware of what they may be letting themselves in for.

    Besides the simple fact that they do nothing for endo, but make it dormant. Doesn't kill it off and it is all still there waiting to wake up when the drug runs out and the pituitary gland wakes up.

    But to be given the option of BC pills by your surgeon is a breath of fresh air to hear...thank goodness you have a wise surgeon there. Much the better option for you and the fact you are wanting to try for a pregnancy soon.

    I would advise you to wait at least a month before gently trying to have sex - because if they have been rummaging round in the POD removing endo from there, it is a wound that will need time to heal and that is right behind the vagina and sex is likely to be rather uncomfy (painful) for a while.

    If it hurts give yourself a week or two more recovery time before trying again. You may find it necessary to take strong pain killer before and after sex because of the pain and if you need that, then do so.

    It can sometimes be easier to adjust your position during sex to make things less painful. ie. you on top

    and perhaps facing his feet.

    The best time to try and conceive is within 6 months of a surgery because your surgeon will have cut back adhesions and spruced up the engine so to speak, so your chances on naturally conceiving are much higher until adhesions regrow and possibly start causing problems once more which they can do.

    If I was in your shoes, I think I would sack further surgery just yet, and make the most of the unstuck ovaries and try for a baby first. It is up to you though.

    If you can get pregnant and carry to term, then it lasts a darn sight longer than any GNRH drug would do, without the ghastly side effects. Pregnancy is a natural way to make endo dormant. To my way of thinking it seems the most logical thing to do next.

    Wishing you a speedy recovery from the op, and Very best of luck baby making.

  • That is the most fantastic reply and am so appreciative!

    I feel very lucky that I haven't experienced the degree of pain that others have but I knew it was severe before she even opened me up due to how things have been in the past.

    Even very early on now I can feel a difference as in there's no pressure on my bladder which feels great! Luckily I've never really had that much trouble with my bowels despite the POD which couldn't be tackled by some colpermin and an occasional laxative and experienced no pain with sex.

    I was very dubious about the injections in my befuddled condition but am pleased to see a specialist to gain a second opinion.

    If we do manage to have a baby I would happily have one and return on the pill as I was on cerezette for eight years blissfully unaware! I would consider a short course of that over any injections as it suited me well but shall wait and see.

    Thank you so much for all your information and detail...and the well wishes x

  • I wish I was aware as you abt prostap as I was told to take it for 3 doses after 1st lap...wish I hadn't as side effects were horrific physically and emotionally. Last jab was a year ago. They gave it to me prior to Ivf to down regulate me. Two failed ivf's then saw endo specialist who said endo was grade 4. I would try naturally for 6 months and then look to Ivf. Since my 2nd lap I've tried 6 months naturally and considering Ivf again, but I have low AMH so additional issues x

  • Thanks for your reply. The more I read about these injections the more I'm really not sure at all. The side effects sound awful and working full time in an active job I think I would struggle.

    I'm struggling with no knowing the full story and feel there's more the gyne should have told me but will have to wait for specialist appointment. I feel that because of the severity of the endo I would happily try for ivf if allowed but it's getting the process going and not sure if I have to go down the route of trying everything else first before they permit that. Will be trying naturally in the mean time whole heatedly so will see what happens x

    Thanks x

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