Endometriosis and Surgery before FET

[Amy2106]

I have stage 4 endometriosis and previously had a bilateral cystectomy in June 2023.

I have since had 2 rounds of IVF, both fresh transfers have ended in biochemical pregnancies. My endometrioma grew back prior to IVF and around 6cm.

I had been on the waiting list for surgery to remove the endometrioma and they happened to call the day of my failed transfer so I need to decide ASAP if I want the surgery but my follow up for IVF isn’t until end of March!!

I have 4 embryos in the freezer currently. Just wondered if anyone who has been in a similar position and did you have a surgery before your next transfer or did you hold off?

Worried about my egg reserve dropping lower- AMH is only 9 but is possibly my endo and the cyst are causing my chemicals!

Thank you !

[Elsiedee87]

I don’t have a solid answer for you but I had been TTC for 6 years, stage 3 Endo with an Endometrioma - 3 rounds of IVF and 2 failed transfers, not a hint of a positive in all this time,

Had excision surgery last May (Endometrioma removed) and fell pregnant straight after in the June!! Sadly resulted in miscarriage, but then fell pregnant again (currently 5 weeks). I have poor egg quality so not sure this will result in live birth - but I am sure the Endo excision surgery allowed me to fall pregnant!! I personally say go for it, your eggs will be safe in the freezer xxx

[Amy2106 in reply to Elsiedee87]

Thank you! I am just worried so worried about my eggs reserve but hopefully the 4 in the freezer will be enough!

Sorry to hear about your recent miscarriage and fingers crossed things look a bit more positive for you this time!

[Elsiedee87 in reply to Amy2106]

Thank you, I haven’t checked my amh yet, but there is some evidence to suggest that removing an Endometrioma may improve egg quality, it just may impact your quantity x

[Travel_lover89]

I agree with  Elsiedee87 . I had exploratory surgery last June to check my tubes and it turned out I had grade 3 endo, an endometrioma and two cysts (infertility and 1 failed round of IVF was my only symptom). They removed everything and I fell pregnant only 2 months after my surgery. It sadly resulted in miscarriage but if it wasn’t for the surgery I wouldn’t have been able to get pregnant at all. My AMH was lower than yours and I would caution that the surgery has caused a large, further reduction (it’s a common result of ovarian surgery). BUT you have eggies in the freezer which aren’t going anywhere and that is fantastic. You can use those regardless of your AMH so would say go for it if they’ve offered it to you. Good luck with whatever you decide to do

[Amy2106 in reply to Travel_lover89]

Thank you for your response! Do you mind me asking what your AMH was before and after your surgery?

It really is a hard decision but need to remember we have our embryos in the freezer !

[Travel_lover89 in reply to Amy2106]

Sure- so my AMH was tested about 5 months before I did IVF and it was before we knew anything about my endometriosis and cysts etc. It was 6.8 then and I had just turned 34 so it was pretty low for my age (it was sort of in the amber range on their very depressing chart..). Then I had it tested pretty much exactly a year later and in that time I’d had failed IVF, the surgery and a miscarriage and it was 3- which is very, very low for my age. My consultant (and she was my surgeon) said that the drop was correlated with the severity of my endo and therefore how invasive my surgery was to remove it and the 2 cysts.

BUT, like I say, if I hadn’t had the surgery it would be physically impossible for me to get pregnant and I did manage to get a positive test. Hope this helps Happy to answer any more questions

[Amy2106 in reply to Travel_lover89]

Thank you. Endometriosis is such a horrible thing to have!

I can see your thinking about doing another round of IVF so hope things go ok for you. I don’t know what protocol you tried last time but I responded a lot better on the long protocol compared to the short if you haven’t tried that already! X

[Travel_lover89 in reply to Amy2106]

Thank you. And yes- I had kept seeing that on different posts regarding the long protocol. Do you mind me asking why they recommend it for you and why you think it worked better? I had the short protocol first time but maybe it was because the clinic didn’t know what was going on inside of me! X

[Amy2106 in reply to Travel_lover89]

I will send you a message as not sure what your allowed to say on these!

[Travel_lover89 in reply to Amy2106]

Thank you! Really appreciate it x

[Robins53]

hello, also stage 4 here and suffered recurrent miscarriages. It’s a really personal decision, but I decided I always wanted to get my body in the best shape to carry a baby. I never had a postive test until after my large cyst was removed in my first surgery in 2019 then I did start falling pregnant naturally. 4 rounds of IVF with my own eggs didn’t work for us.I had more comprehensive excision surgery in 2021. Still couldn’t stay pregnant but my body felt great and cycles more ‘normal’. We did get ivf success in 2023 tho I did move to donor eggs as well and now have a 14 month old baby girl. I am 100% sure having the surgeries helped me to have a successful pregnancy (as well as moving to donor eggs)

Personally, I would always be wondering ‘what if’ if I didn’t try the surgery first. You can also ask the surgeon to be ultra conservative removing tissue around the ovaries . Good luck with everything and be kind to yourself! Once you make the decision you will feel less stressed x

[Amy2106 in reply to Robins53]

Thank you for your response! Glad you got your little girl and nice to hear that it can be possible.

Yes I think i will constantly be thinking what if especially if the next transfer fails so need to be fortunate that we have our 4 embryos in the freezer waiting for us!