Fertility problems, possibly endometriosis? Any ideas?

[meroving]

I hope somebody can help, I posted a little while ago but have since had tests and a scan.

We've been ttc for over 18 months (we already have existing children, no fertility problems before), unsuccessfully.

I have a 28 day cycle, but get pain stomach cramps, both sides, and lower back pain on day 21, then some spotting a few days later and then AF starts, which is painful - but has always been so.
I also get some pain (lower abdominal cramps) after sex, and milder abdominal pain sporadically, on-and-off. I think it is getting a little worse. I'm finding now that I have a 'window' of no pain a fews days after my period, but the rest of the time am likely to have these cramps, I tend to take Feminax for the pain, which dulls it a little.

I had a urine test and a scan earlier this week (looking for PCOS etc) and all is clear. I'm going back to the doctor shortly, but wondered if anybody had advice on what it might be useful to know or ask.

Any symptoms that are cyclical in nature and get worse up to and including menses should be checked out properly by a gynaecologist (not the GP) to see if endometriosis is present (reading your symptoms to me seems very suggestive of endo, am no expert but was diagnosed with endo some years ago). I would also now keep a pain and symptom diary to log your period and all your associated symptoms if you have not already done so.

Have a look too at www.endo.org.uk; there is some useful information on there as well.

At 18 months of ttc as well you should ideally be already under the care of a gynaecologist at a subfertility unit; also by now your man should have been tested as well to see if there are any male factor issues.

BTW endometriosis is not picked up on any type of ultrasound scan as these deposits are so very small. The usual way endometriosis is diagnosed is through a keyhole surgery op called a laparoscopy.

any other questions just ask.

Thank you very much for your help. A pain diary was suggested, only yesterday, so I'll definitely start that.

Yes, I am on day 25 and the pain has (as usual) been steadily increasing, am taking ibuprofen at present. The GP said Endo was very linked to cycle and didn't think mine seemed to be (despite my mentioning pattern of always appearing on day 21), because mine seems also be brought on by overexertion, e.g. physical exercise.

He did suggest the contraceptive pill, until I reminded him about ttc.
I delayed seeking help for infertility, as I only finished breastfeeding my youngest child (at just post two years) a few months ago, and thought the breastfeeding perhaps responsible.

Yes, the sonographer did mention not being able to see signs of endometriosis. She also suggested I ask to check if I was indeed actually ovulating.

So I need to be pushing for referral really? I do hope they don't try to fob me off with pain killers or the contraceptive pill again.

I would be pushing for a referral if ttc and no luck after 18months. irrelevant about the breast feeding as breast feeding only deemed to have a contraceptive effect for 6 months if demand feeding and through the night. I guess may lower fertility a bit but not if you were ovulating. It would be extremely to put you on a contraceptive pill if trying to conceive. Whilst referral being waited for gp can do day 3 and 'day 21 ' bloods, check DH sperm and then send results on.

Good luck

Oh forgot to add also pushing painkillers not appropriate if ttc as should avoid ibuprofen and other NSAIDs. paracetamol is fine

Thank you, this is all helpful

I did (I think) detect a lack of sympathy about the ttc as we already have children, when I mentioned that the doctor said 'presumably you already have children?" "That's fine then."

Oh dear, I have been taking ibuprofen too. But I'm on day 26 of 28 (woken up by the pain during the night).

Assuming it is endometriosis I have. Is it possible to still get the pains and actually be pregnant? I've always thought it was over for pregnancy after the pains have started? If that makes sense.

AFAIK, a urine test cannot detect PCOS. It is usually diagnosed from a combination of symptoms such as hair, acne, etc, blood tests for the hormones LH and FSH and a scan of the ovaries so I find that part odd.

That sounds like a lot of pain. I hope it get's better.

Thank you. Sorry, that's my fault, the wording.

The urine test was just to rule check for uti etc, apparently. The scan was to rule out the PCOS, amongst other things. Though I couldn't see I had any obvious pCOS symptoms upon researching.

Hi Meroving, I've read your thread with interest. I'm suffering awful mid-cycle pain that disappears for 10 days or so following AF. I have 2 children, and was lucky enough to conceive them both within 2 months of TTC. I came off the pill 3 months ago in preparation to TCC DC3 next year, and that's when these symptoms began. I don't think I have any other signs of endo - periods are regular (28 days), normal in flow, length and not particularly painful, but the pain leading up to AF is rotten - almost feels like it's in my bottom sometimes too. Had an internal scan last year because experienced a similar episode of pain then (not on pill then either) but nothing was found - appreciate this would not have identfied endo. Anyway, preparing to TTC next month and have fingers crossed it will be as straightforward as last time, but I do wonder if I've developed endo since my last pregnancy and may encounter some problems? Perhaps the pill was masking it?

I'm not sure, Mummypirate. Perhaps it does mask the pain and other symptoms, I don't know, only that it was something the doctor suggested taking.

I don't think your symptoms sound too dissimilar to mine, though (be that endo or not). My only real break from period type cramps is just after AF, for a few days, too.
Good luck with ttc!