Endometriosis and IF Treatments

CandaceC1020 · December 2013

So, I fairly sure my endometriosis has come back and is one of the reasons why I haven't been able to conceive on my own. I'm not positive of this, but I'm pretty damn sure. The telltale signs that I had years ago have come back.

I have an appointment with Shady Grove Fertility next Friday. I haven't had infertility testing before (Hubby has not had SA), so I think they might start there.

I'm wondering how your doctors handled moving forward with Endometriosis.
Did you have a Lap right away?
Did you try treatments and begin with an IUI or even naturally?

I guess that I'm just fearful that endometriosis will push me right to IVF. Unfortunately IVF isn't covered by my insurance (AI and IUI are covered).

Give me some hope ... or guidance ladies. Please.

rox825 · December 2013

Hi... I don't have confirmed endo but I've suspected it for a while because of family history and the fact that we've been unexplained. I've seen 3 REs for various reasons and they all suggested starting with a few treatment attempts first, before trying a lap. I decided to go this route, try a few TI cycles and 2 IUIs before doing a lap. I ended up with a BFP on IUI 2 that ended in MC so now I'm re-starting, 2 more IUIs and if no success then we might consider a lap at that point.

I know others here did the lap first and were glad that they did. It's a personal decision, but unless you have really advanced endo and/or other IF issues that come up during your testing, you don't necessarily have to start with IVF. Good luck with your testing!

Milagros315 · December 2013

I had the surgery in August and I kind of wish I didn't because it didn't improve my pain and we're probably moving to IVF anyway. We decided to skip IUI because we're 100% out of pocket and the stats aren't that great for IUI with endo. Since we're OOP it made sense for us to save our money and spend it on a better chance with IVF.

If we had insurance coverage for IUI we definitely would have tried that first (Femara hybrid or injects - my RE doesn't like Clomid). I would probably want to at least have exploratory surgery first because I wouldn't want to waste time or money on IUI cycles if there was not a chance. Especially if your insurance only covers a few cycles. For example, I had cysts on my tubes and a large polyp in my uterus that didn't show up on ultrasounds. Those definitely needed to be removed even if we left the endo alone.

NotSoPatientlyWaiting · December 2013

I had my first lap back in 2011, which is when I was officially diagnosed with stage 2 endo. During the surgery, my RE also found uterine polyps, which she removed. We tried naturally after that with no luck.

Fast forward to October 2013 - I had my second lap to remove any endo that had come back and also a hyteroscopy to remove a few new polyps that were found via saline sonogram. We were advised to be as aggressive as possible following the lap, because endo tends to come back pretty quickly. Your best chance of success is within the first 6 months post surgery.

The very next cycle after the lap, we started a combo cycle with femara and follistim. Unfortunately, we got a BFN in November.

We are currently in our 2WW after IUI#2 on 12/5.

My RE recommended the lap if we were going to give IUI a try. She said that our chances would be tiny if we didn't. Removing any endo prior to starting any IUI cycle certainly ups your chances. We have about a 10-15% chance of IUI working, after the surgery.

If IUI #2 ends up being a BFN, we are going to give IUI maybe one more try, or possibly move straight to IVF. My RE did say that a lap would NOT improve our chances with IVF.

I'm really glad that we did the lap, because it armed us with valuable info moving forward to give us our best chances. The surgery isn't a bad one, and I'm a wuss when it comes to that sort of thing! LOL. In the end, a lap is really the only way to be 100% sure about whether you have endo.

gsancho · December 2013

I was pretty confident I had endo, so I did a lap right before any IUI treatments. However, we are fully OOP for IUI and my insurance covered most of the lap - so that played a big role in the decision to do the lap ASAP. I know my RE at the time had said the protocol for us would have been to do IUI regardless, so she had said we could still do the IUIs before the lap if we had wanted. It's always tough b/c there's never a clear answer!

formerwigirl · December 2013

I also decided to have a lap because we are "unexplained." My RE suspected endo due to family history and my painful periods. She gave me the option of doing the lap then IUI or just start with IUI. The ladies here helped me big time by their advice. I decided if I was going to go ahead with IUI I wanted the best chances. Plus I needed to know if there was something there or not. I was afraid I would do IUI and get all BFN's and be left wondering what if I had done the lap.

Fast forward I did my Lap in September and Stage 2 endo was found. My insurance covered 90% of my surgery so I am still paying off my balance to the hospital but I think it was worth it. Good luck in making your decision!

CandaceC1020 · December 2013

Thanks ladies. I want to be prepared when I go to the RE on Friday. I want to discuss the probability of the endo coming back ... and I'd like to start things with a clean uterus (aka clean slate). I think a lap would help me feel better about things - what if I don't do the lap and the IUI and IVF doesn't take? I hate wondering about the 'what ifs,' but I don't want to be sorry about not trusting my gut.

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Endometriosis and IF Treatments

Re: Endometriosis and IF Treatments

Me 33, DH 37 -- TTC since Jan'12 -- Low AMH (0.78) & endo, SA w/ low motility
IUI's 1-3 = BFN, IVF converted to IUI 4/13 = BFN
IVF 1.2: 8R 6M 4F -- 2 blastocysts frozen, FET 8/15 = BFP!!
Beta #s = 445;1,098; 9,545 -- EDD 5/2 -- Team Pink!

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Endometriosis and IF Treatments

Re: Endometriosis and IF Treatments

Me 33, DH 37 -- TTC since Jan'12 -- Low AMH (0.78) & endo, SA w/ low motilityIUI's 1-3 = BFN, IVF converted to IUI 4/13 = BFNIVF 1.2: 8R 6M 4F -- 2 blastocysts frozen, FET 8/15 = BFP!!Beta #s = 445;1,098; 9,545 -- EDD 5/2 -- Team Pink!

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Me 33, DH 37 -- TTC since Jan'12 -- Low AMH (0.78) & endo, SA w/ low motility
IUI's 1-3 = BFN, IVF converted to IUI 4/13 = BFN
IVF 1.2: 8R 6M 4F -- 2 blastocysts frozen, FET 8/15 = BFP!!
Beta #s = 445;1,098; 9,545 -- EDD 5/2 -- Team Pink!