Endometriomas and IVF

[discobec]

I had excision with stripping of bilateral endometriomas last November. I recovered really well but my pain returned a couple of months later.

I have recently had an ultrasound scan which showed a 1cm endometrioma in my left ovary and a 5cm one in my right. All of my pain is right sided and it's worse than it's ever been. I'm currently mid-flare up and I'm in agony.

However, my husband and I have recently been called forward for IVF, which we've been waiting a long time for. Just wondering if anyone has had experience of IVF combined with endometriomas and how did you find it? Or did your consultant suggest they were removed prior to starting?

I'm in a dilemma in that I don't want to wait any longer for IVF and I'm concerned about my egg reserve diminishing with more surgery (I'm 36 and not getting any younger), but I'm not sure I can live with the pain either. I'm also concerned that IVF might exacerbate my symptoms.

Any advice?

[me08]

I am in similar boat as you and my consultant has recommended surgery before we proceed. My injections have been sitting in my fridge and in my bedroom since March. I am now waiting for surgery date and praying all goes well.

All the best with whatever you decide x

[C_L_A_I_R_E]

👋 discobec, I have been through similar issues with endometriomas. I had one drained (left ovary)in my first laparoscopy but 6 months later it had returned. By then I decided on ivf ( tried naturally for over 6 months first) . The ivf clinic decided to drain it and then start the stimming (I went straight into the short protocol). However the endometrioma refilled again during the process! This ivf 1st round ended in a bfn. So the clinic advised permanently removing the cyst which meant removing part of the ovary. As my cyst ovary (the left) only stimulated to 4 eggs I decided to go ahead. So now I'm mid cycle 2 for ivf and no cyst 😃 and hopefully better quality eggs! Waiting for my day 3 embryo call today! 🤞🏻🍀❤️🍳

[NDE1987]

Hey Hun, I myself have endromesosis. I had surgery back in 2013 and 2015. And I started my ivf last year where I had a 5cm cysts on my right ovary. I was told that it was ok to carry on. If they thought it would hinder the ivf they said they would aspirate it. However they left it after doing a blood test as it was ok. That IVF cycle failed. Since then I had another ivf cycle in may and again the same cyst is there. Again my ivf failed. I now have frozen embryos and I am hoping to get more tests done before I have a FET. My right ovary is actually in alot of pain the last two days as I am ovulating. I feel like I need another op, but like you say I don't want to keep having endless operations and it to affect my egg reserve which is already low for my age. I'm 30 and my AMH level is 8.4. or should I saw was last year!!! Best of luck. Maybe go to your ivf appointment and see what they suggest xxx

[Linda78]

I know the dilemma you're in and I don't think sadly there is any easy answer - endometriosis seems to effect fertility in unique ways for each person and treating it also seems to have both an adverse and positive effect...after being put forward a couple of years ago for IVF we found out I was pregnant naturally at 37 but tragically miscarried just before the 12 week scan and they believed that my mishaped uterus and the hostile environment from the endometriosis were to blame so I had corrective surgery last April with a view to starting IVF at the end of last year - by the time the coil was removed post surgery in July quite a lot of the pain and endometriotic masses had already returned but I was 38 by then and advised just to push on with IVF - after several failed starts due to new cysts appearing and disappearing and not being able to access my right ovary at all due to a 6cm chocolate mass the IVF started in February and miraculously I got a BFP in April and am now 25 weeks pregnant - really can't believe i have got this far but after 5 years of trying and endless confusing and contradictory consultations we are here - what I am trying to say is don't give up - endometriosis is a confusing condition and there seems to be little research that goes into it - take advice from the hospital but also follow your own feelings - I also saw an acupuncturist who specialised in endometriosis throughout my treatment and she was amazing at advising about diet etc to try to lessen the effects of flare ups during treatment so that might be a route for you to investigate if they recommend you continue with treatment - wishing you all the very best x

[discobec]

Thanks for your advice everyone. We have an appointment next Tuesday to plan the treatment so will hopefully have a better idea of how to proceed then. X

[Hidden]

I had bilateral endometrioma prior and during IVF. Mine were 4cm. I think 4cm is the general cut off size.

I wonder, if you go on Syneral say, as the down regulation prior to IVF, could that shrink them?

Oxford decided to not operate on me, because Id already has 2 ops on the ovaries and AMH was 3.2.

Seems it was the right decision. I was on long protocal, Synarel sniffers 2 x twice daily and strongest GONAL F dose. My left ovary did not respond at all, just produced a cyst but the right ovary, I got a lot of follicles after a slow start, got 8 or 9 eggs, 6 fertilised well and 5 went to blastocyst. I have my toddler now. I am now thinking of a sibling with my one and only frostie.

So it can work, but I realise I was lucky.

Good luck with the appt - I realise this is a real dilemma... let us know how you get on and i am sorry you are in this situation. xx

[Hidden in reply to Hidden]

ps i was nearly 40 when having IVF.. if that helps. xx

[sunset212]

Hi as you are still young your egg reserves should still be okay. Ordinarily they usually advise not to remove endo cysts but as yours to the right is over 4cm the consensus is to remove simply because they can interfere with the collection of eggs or get accidentally touched abs bleeding can occur during egg collection which can be serious. With the pain it is causing you also it would be sensible to drain it before doing your ivf rather than cut it out as that way your precious egg numbers are not affected. That’s what my clinic advises anyway and they are pretty top in all they do. I had 2 small ones on one ovary and first round of ivf I now have 2 children so hope is not lost. Is your AMH ok? X