surgery or IVF

[TeddyBear24]

I’ve been given the choice depending on my priority and I’m stuck on the decision.

AMH level is 17

2 endometrioma in left ovary, right ovary clear, womb clear, ademyosis. Potentially blocked tubes. Retroverted womb. Bowl and utinary tract stuck to my womb just to give context. Partners semen test all fine. Been off the pill since June with no luck.

Option 1- surgery

This will clear the endometriosis, unblock tubes, fix what they can. Could reduce my already low egg reserve. Would have to wait a while before trying to conceive again. But gives more likelihood of conceiving naturally

option 2- IVF

Better chances of conception maybe? Targeted for conception rather than just waiting for nature but isn’t fixing the condition. Although symptoms would go away with pregnancy and could have surgery after to fix it. I’m petrified of needles though!

Our main goal is conception so we’re swaying towards IVF for the better likelihood of pregnancy but open to others opinions whether surgery would be better?

[Amy2106]

Hey,

I had surgery last year and my AMH is now only 8 and one of my cysts grew back within 3 months of my periods returning. Unfortunately my cysts were 10cm and 6cm so I had no choice but to have them removed prior to IVF. We also tried naturally 6 months after surgery to get NHS funding and this is when my endometriosis was back to square one!

Our first round of IVF ended up as an early miscarriage. I have been advised to go ahead with the next round of IVF before having surgery due to my AMH and all my mature eggs came from the side with my cyst.

I found we got a lot of conflicting information about surgery or not surgery so if you are going privately I would speak with the clinic and see what they advise!

If our next transfer doesn’t work I would think about a freeze all and then have surgery if that is an option for you!

[LME5]

That's a tough one!

Endometriosis and adenomyosis = inflammation. Inflammation doesn't make for a very hospitable environment, so my main goal would be to lower inflammation by any means necessary - diet, supplements, surgery.

I've heard with some IVF clinics, they administer some kind of medication to lower inflammation somehow. I'm not entirely sure how. I heard about it in a Diary of a CEO podcast with Dr Natalie Crawford. Worth listening to (if you haven't already) so you can use it to question fertility doctors if thinking to go down the IVF route.

If it was me, I'd want to treat my endo first before trying to get pregnant. Endo symptoms can return (& with a vengeance) post-pregnancy as hormones try to re-balance. I would want to try to mitigate as many compromising factors with my own health first, before introducing a baby.

But that's just me!

By the way, I didn't think 17 AMH was low. I guess it depends on age!

[MD54999]

Hey I had the same options presented to me when I started trying to conceive. My AMH was 14, I had endometriomas on both ovaries and also endometriosis on my bowel and appendix. I spoke to the fertility clinic and an Endo gynaecologist and both felt it was worth trying IVF first before opting for surgery, due to concerns around damaging my egg reserve. I had two cycles and two embryo transfers that failed and then I decided to do the surgery (and my fertility clinic strongly advised it at that stage) The clinic were also having trouble accessing my follicles for the egg withdrawal due to the endometriomas. It is different for everyone but my AMH only went down to 12.9 after the surgery and no follicles were damaged so they felt it had been a success. I did another two IVF cycles and I'm now 28 weeks pregnant from my 4th cycle (4th overall transfer) so I really felt that it made a difference for me! I felt it was really trial and error with IVF at the start as some people have successful outcomes even without the surgery, I would definitely push your clinic to give a view on whether you need the surgery or if they think you should try IVF first.