Effect of endometriomas, cysts and polyps?

[Goldenfeather123]

Hi ladies, I'm 38 and have failed 3 IUI and 1 IVF (a fresh transfer and tested negative) between last Sept and this Aug. Not sure how to proceed.

In my 12/8/22 scan there were 3 endometriomas (20, 21 and 33mm) and a simple cyst (21mm) on my left ovary and 1 polyp (11x6mm) in my uterus, all relatively small. They were not seen at the very beginning and gradually developed maybe partially due to my age and partially all the treatments. The question is: did these abnormal growths cause all the above failures by preventing implantation? If they did I should get them removed before any more IVF cycles. However, another concern is: could the procedure of removal potentially cause damages to my ovary/uterus? How big would be the risk?

Now I'm thinking to do 3 IVF cycles and freeze all embryos, and do frozen transfers after removing all the endometriomas/cysts and polyp. Is this a good or bad strategy? Can 3 cycles (up to freezing down all the embryos) be finished within 3-6 months (before a removal can be arranged and carried out)? Or better to do 3 IVF cycles with all fresh and frozen transfers ASAP before the endometriomas and polyp grow to a real problem?

Any thoughts and ideas? Or experience?

[Roobs33]

Heya, Sorry you’re having to make some big decisions, have your clinic suggested a plan for you?

I’ve got endometriosis stage 4 and had surgery to remove, including removal of a large endometrioma on my left ovary. Almost a year later I did my first round of IVF, I did a fresh transfer which was negative and a second frozen transfer which sadly ended in a missed miscarriage around 8 weeks. I had no more eggs so decided to wait 3 months to prepare for another round. My clinic suggested that I could do the EMMA test to check the uterus and that my husband could have the DNA fragmentation sperm test. There is the ERA test too which tests for the best window of implantation. Our tests came back ok apart from they suggested that I use canesflor pessaries as my lactobacillus in the uterus was low.

The only other thing I did was take a few extra supplements, like coq10, omega 3, probiotic & a natural pre pregnancy one all in the lead up to the most recent round. During scans for this round whilst I was on the stimulation meds, they discovered 3 endometriomas on my right ovary. I felt really low about this and I felt that I had no chance. Thankfully this recent round with a fresh transfer ended in a positive test and I’m almost 8 weeks. I honestly felt like I was doomed. It is early days and I’m hoping the cysts won’t cause any issues.

I know that having cysts removed can lower egg reserves, so I would definitely say leave them for now especially as they aren’t too big. I don’t have any experience with polyps though i’m afraid. I did do acupuncture leading up to and around both transfers that implanted. Im not sure if that’s a coincidence though but it did help relax me and it’s meant to help blood flow.

Sorry if I have mentioned things you already know about and have tried but just thought I would put down what I’ve done so far. I got a lot of advice and ideas from this forum.

Wishing you loads of luck going forward xxx

[Goldenfeather123 in reply to Roobs33]

Thank you so much! I registered to this forum 2 days ago and already gained a lot info by reading the available posts.Yes, I now tent to leave the endometriomas (because they are not very big) and only to have the polyp removed (because it may effect implantation). Some people said small polyps can be removed quickly and a new IVF cycle can be started soon. Others said polyps can be removed during egg retrieval and frozen transfer can be done afterwards.

Hope those endometriomas in your ovary don't grow further or supressed with onging pregnancy. Whishing you lots of luck!

[DianeArnold Partner Nurse Fertility Network UK]

Hi Goldenfeather. My thoughts would be to get all these "bits" tidied up befor moving on to further transfers. The removal of endometriomas can result in the loss of a bit of ovary, so get everything explained before proceeding, if you decide to. Hope all ends up well. Diane