Severe endometriosis undergoing IVF. 300ui of meriofert for stimulation. Will this high dose cause greater pain. Many thanks in advance.

[HopefulBee]

37 year old woman. Severe stage 4 endometriosis. Unable to conceive. Surgery May 2024 revealed bilateral endometrioma 9cm and 10cm inside ovaries plastered to back of pelvic wall and attached to bowel. Left fallopian tube wrapped round and stuck to left endometrioma and left endometrioma receiving blood supply from omentum ( fatty layer protecting abdominal organs). Tubal dye test revealed both fallopian tubes blocked and left fallopian tube damaged.

Deepset bowel involvement.

Surgery ablation. Informed further Ssurgery needed by specialist centre after family complete.

AMH level 8.8, all other hormone levels normal. Low immunity. Iron deficient on oral iron.

[Endofitall]

I am sorry to hear this. I don’t think the dose specifically is a problem. They use the dose based on your AMH to try and get good response from the ovaries. The number of follicles that respond will produce oestrogen and this is what will usually have the potential to flare the endometriosis. I did find by middle to end of stims my endo was exacerbated. And the more IVF cycles I’ve done the worse it got because of repeated stims. I hope you get your BFP and baby soon and respond quickly. Best of luck.

[Behind_Hazel_Eyes]

Hi I have stage 4 and just about to turn 37! AMH 6.6. been trying to conceive for 7 years. I have done 1 cycle. I was on a high dose for stimulation. I didn't flare. But I was also on an anti-inflammatory diet. I was slow to respond and needed a few more days of the drugs to get my follicles to respond. Unfortunately I only got 2 eggs becuase they couldn't access both ovaries because of the endo. Both eggs were poor quality. They didn't last 24 hours. I have a lot of endo round my ovaries (kissing ovaries and 2 cysts), never had any ablated or excised. Going for excision surgery next week. Like you my tubes are not great, one is also getting removed. Endo is such an awful disease! Wishing you luck!

[BlueEyedTabby]

Hi there, I'm so sorry to hear how extensive your endo is. It's such an evil disease and I can imagine you must be in a lot of pain as it is. I have stage 4 also and my stims were 350 menopur. I didn't find the pain flared up during stims specifically but I have had more flare ups over the course of the cycles than I think I would have had normally. I flared up during down reg which surprised the nurses 🙈 I spoke to my endo consultant who told me IVF doesn't drastically exacerbate endo and down reg can keep it at bay a little bit. Wishing you all the best for your cycle xxx

[Eternalwarrior]

Hello lovely,

I am so sorry to hear about your endometriosis. I also have DIE and had bilateral endometriomas and endo in my bladder and ureter, plus adenomyosis. I spent most of my thirties trying to be a mum (I am now 40) and had multiple treatments, IVF and surgeries. I am sorry if my experience is not what you want to hear, but every time I was on stimms, my endo/adeno flared up very badly. I did have excision surgery for endometriosis at a BSGE accredited centre (I needed a multidisciplinary team) before my successful FET that gave me my son. So, I hope this gives you hope! Severe endometriosis is a horrible disease but the anti-inflammatory diet did help me a bit. I was told after I had an MRI done that I had hydrosalpinx and my tubes would need to go but when they did the surgery, they told me it wasn't hydrosalpinx as such but a massive endo nodule that they excised... They always advise to remove the fallopian tubes if they are blocked, as it can affect implantation. Wishing you all the best xx

[HelzBelzUK]

I had stage 3 silent endo.

I was ok on stims (before surgery) it was when I started oestrogen for FET that the pain increased.

My husband and I ended up paying private for surgery after I was told I had a blocked fallopian tube and it was potentially causing implantation failures.

Falllopian tubes were fine but I had stage 3 endo with bladder and bowel involvement and cytsts. I done prostap for down regulation before transfer

My friend has stage 4 endo.. hasn’t had any surgical intervention, decent AMH, didn’t do any down reg just had 300iu menopur for stims. She got 26 eggs and 11 embryos. She’s now 30 weeks pregnant so there is hope xx