IVF After Extensive Surgery?

Hi All,

I've just had a robotic surgery to remove extensive Stage 4 endo, really glad to have had the surgery as have had a pretty difficult time with finding the right Drs etc to diagnose and treat this condition. My surgeon in the end was one of the best and a lovely man who made me feel relaxed.

The background is I am came off birth control last year after getting married and tried to conceive for a few months (after a previous surgery to remove my appendix which was found to have endo). I am now 38 years old.

I am well aware that I am fertility wise in a very difficult situation. The Dr has said that I can try and conceive as ovaries, tubes are clear and free after the op. I was ovulating and getting my periods regularly prior to surgery. (Very painful though.)

I have spent my recovery time reading up about IVF etc as I know it is highly likely that we may need this. The rate of success that I have been quoted is quote low - maybe 15-20% and due to where we are living currently very expensive, but we could afford a cycle if we needed to. (Multiple cycles are unlikely because of the cost and I know people usually need three of four).

I am very confused. I'm still healing I know and possibly feeling rather depressed because of the struggle its been to get proper treatment. I'm worried about the Endo coming back if I try and conceive naturally and if we go for IVF. I am not sure if I want IVF as it will mean time off work (I am sure work are getting sick of me - two major surgeries in two years and my job is stressful.) We should be in a position in a year to move and have IVF covered by insurance (hopefully) but I will be 39 years old. I am aware of course that time is a huge factor. I had an AMH test about six months ago and it came back with a good result for my age.

I probably need proper counselling. But I am hoping for advice for those who have been through the process. Please does anyone have any words of wisdom for me? I feel like I am going through hell and find it very difficult to talk to friends and family about this.

Thank you for taking the time to read and respond.

Star7 xx

6 Replies

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  • Hi - there really is no way of knowing what your IVF chances will - apparently the average success rate for a healthy woman of any age is only 25% so multiple cycles would usually be required in any woman to up the odds so that is a choice only you can make if only one cycle is available. But as your ovaries and tubes are clear and you have had all your endo excised and appear to have good ovarian reserve I should think you should try natural conception for a while yet to maximise on those benefits. There are likely to be many aspects to infertility with endo other than the actual 'equipment' being in tact that are not fully understood, perhaps related to the autoimmunity aspects, but many women do conceive, especially after a thorough surgery when there is no active endo to disrupt the hormones. You would normally take clomid first before IVF so is this being considered? I should think this would be the next consideration if you fail to conceive after a couple of attempts. The length of your cycle is very important to since you need a luteal phase of at least ten days to have a good chance of natural conception - the period between ovulation and your period. Do you know how long your is? x

  • Hi Lindle,

    Thanks for your reply. I'm weighing up the options as much as I can and was thinking about trying naturally for a few months again but am just very concerned about my age.

    In the few months we were trying I tracked my cycle and was generally ovulating between day 10 and 14, cycle length of 28 or 29 days. So pretty regular. I do think stress has a huge effect on me as I think I had one month where I was very stressed and maybe didnt ovulate, as had a 32 day cycle with no cm. Tested then as was concerned about ectopic. I've read as much as I can about the effects of endo being an autoimmune disease and am just concerned that there could be other things going on. However after only trying naturally for six months I don't think I've given it very much time.

    Everything I've read about clomid suggests it should be used for PCOS, and the tracking and a blood test have shown I ovulate. Have you any further info about the use of this drug for endo?

    I just don't really want to have ivf, if I am honest. I've found the last few months so stressful, I've really had to work hard to find the right surgeon. We can pay for a go this year if we need to and have insurance in place for a years time, to cover any further surgeries and ivf.

    Thanks for your response.

  • Hi - I missed that you have PCOS so this info might help. advancedfertility.com/clomi...

    Your cycle sounds fine as you have a good luteal phase. One thing that worries women is natural killer cells that are thought to make the endometrium hostile which is likely to be associated with the autoimmue aspects of endo. You can be tested for it but this article by Sir Robert Winston might be useful to you in relation to IVF.

    genesisresearchtrust.com/Bl...

    My concern was that you might pin all your hopes on one IVF cycle to find it fail and perhaps miss your best window for natural conception which is definitely found to be at its best after a good lap. If you do manage to get private cover then I guess you can have the best of both worlds and try naturally until that time. I think with good tubes and ovaries and no endo the chances are probably better than with IVF. It is said that you have a fertile phase as you approach perimenopause as the body decides to have a last attempt at pregnancy. I conceived naturally at the first attempt at 40 and have my one beautiful son as a result. I do hope you are successful. xx

  • Hi Lindle,

    I don't have PCOS as far as I am aware and no signs that I do. That's why your comment about possibly using clomid confused me. I thought it is used for PCOS not endo.

    I am in agreement that these few months after the surgery are a good time to try naturally. We could then try with ivf later in the year if needed and then use the insurance next year to cover any further cycles.

    But I just keep coming back to my age. You were very lucky with your experience, with stage 4 endo it is hard to be hopeful.

    Thanks for your response and the links, I've also been reading about killer cells etc. Its amazing what is known now and I'm thankful that I'm alive now and not 50 years ago.

  • Ive got severe endometriosis (was never given a stage, he just said its severe and very unlikely to conceive naturally) we tried naturally for 5 months after my lap but the endo came back really quickly and worse than before.

    Had 2 laps in 9 months to remove the endo and adhesions etc, also needed decapeptyl injections

    we were given a 33% chance of IVF working… it worked first time,

    we didn't have many eggs, only ended up with 4 embryos, and only 1 made it to being transferred… she's now a beautiful 19 month old. we have no embryos frozen, but it only takes 1!

    Easy for me to say now Ive done it, but keep positive. At the time I said I would never put myself through IVF again, but we are now planning when to start again.

    Got everything crossed for you x

  • Thanks milli-fran for your hopeful comment, its lovely to know that it does work for some people. May I ask how old you were when you conceived. I really hope it happens for me. I hope the second round goes well for you. x

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