Did your Endo come back with vengeance

[JJB92]

We are struggling with secondary infertility. I'm considering a laparoscopy for possible endo but I don't know whether I want to go that route.

Did it actually help you fall pregnant?
Did it come back? Was it better or worst than before?

If I do have endo (not sure), my symptoms are not too bad, and I'm scared operating on it might cause it to become worse over time.

Please share experiences and advice.

Thanks

I’m not TTC but I do have endo and had a lap last year for it.

I’m not sure if there’s any scientific backing but yes fertility does seem to improve post op and women fall pregnant easier.

Endo will always come back - even after a hysterectomy it can come back! I don’t think it necessarily comes back worse after a laparoscopy.

I wanted to have my operation to clear the endo I already had and make sure the adhesions etc didn’t get worse in order to try and preserve future fertility.

Have you had an ultrasound or MRI to see if anything can be seen? Endo isn’t always seen on either but it’s worth checking.

I have endo and had a lap in about 2013. I had a Mirena coil at the same time which pretty much stopped my periods and pain. I then had the coil replaced in 2018 before having it removed and TTC in 2021. It only took me 4 cycles to get pregnant then including a chemical pregnancy so I didn't feel that the endo had affected my fertility at all. I then didn't have periods for 10 months postpartum and when they came back I didn't feel it had come back with a vengeance, in fact I think the pain was less bad, if anything. This time round I got pregnant first cycle.

I think there's quite a woolly relationship between symptoms and severity and fertility but I think some people have found that laporoscopic treatment has helped. There is also the slight risk of complications from any surgery that have to be weighed up against everything else too.

Thanks you for sharing experiences @SizzlingPrickle and @Mielbee ! I'm so glad for you that you did not struggle falling pregnant with endo @Mielbee .

I haven't had an MRI done, but have had a lot of ultrasounds. Haven't picked anything up there, but I have some symptoms that point to it according to my fertility specialist. I didn't even realize it was a possibility for me until he pointed it out.

Sorry OP, my message was insensitive - I didn't register that you are struggling with secondary infertility. I'm sorry that that's happening for you - it must be so hard. I really hope it works out for you soon!

I have had two laparoscopies, five years apart. The first one dealt with 'mild endometriosis' along with drilling my ovaries and checking my tubes. I fell pregnant a month later.

The second lap was to repeat the drilling to conceive again, and this time he dealt with 'mild endometriosis' again so in five years it had returned. There were a number of reasons why I didn't conceive second time. Ended up doing icsi.

So, in my experience the endometriosis returned to its original state within five years following a full term pregnancy.

A laparoscopy is not a walk in the park, it easily takes a week to recover and is very sore for the first few days. I only had the surgery as I had exhausted other options on the nhs so I was willing to give it a try.

Agreed @Puppupandaway - I was signed off for 4 weeks after my op, I extended it to 6 weeks but could have done with 8 weeks as I was just so tired!

@Mielbee no worries, but thank you.

@Puppupandaway amazing that you conceived straight afterwards the first time. Definitely makes me more inclined to go that route

@JJB92 The burning of the endo was done as an after thought though as the main objective was to fix my pcos with ovarian drilling. That is how I conceived. Don't know whether treating the endo had anything to do with my success first time.

Have you had any other testing?

@Puppupandaway yes we've done all the basics. HSG to check the tubes. Blood tests to look at things like thyroid, prolactin, STIs etc.

Everything is also good on my husband's side.

My ovulation is considered "poor" but we've been treating that with letrozole, trigger shots and supplementary progesterone. Our 6th medicated cycle just failed that's why I'm wondering whether to get a laparoscopy or whether we should just go straight to IVF (very expensive obviously but hopefully a much quicker path to success)

Why is your ovulation considered poor? Has that been investigated? If it's pcos, then definitely have a laparoscopy. Have you got time on your side though? If you're close to 40, ivf might be best rather than waiting for a lap then ttc for months to know whether it's worked.

Without ovulation induction, my follicles mature very slowly. Eventually I seem to ovulate, but only around day 20 of a 28 day cycle. My luteal phase has consistently been 8/9 days for months.

My progesterone also stays very low - high enough to indicate that I probably did end up ovulating, but still less than ideal. We've tracked it over multiple months and also testing multiple times per cycle and never got a decent test result.

I don't have PCOS, so I'm not really sure why my ovulation is a problem, but at least that part is relatively easy to treat in my case.

I'm 32, so I technically still have time, but for various other reasons (age gap, work situation, husband's age etc) we've decided that we will only keep trying for a second for another year, so time is of the essence. We may obviously change our minds if we still did not manage to conceive a second by the time we reach our "deadline", but for now we really want to give ourselves the best shot, it's just difficult to know that "the best shot" entails given that we obviously do not have unlimited budget to work with

What a nightmare for you. If it's was me, I'd forget about the laparoscopy and get started on the ivf process. If your ovulation has been an issue, ivf meds will ensure it goes like clockwork. My dr told me that he thought we had an excellent chance at ivf due to my only issue really being down to ovulation. He was right! In the end it turned out we had some male factor problems too so we used icsi but the process was the same as ivf for us. It worked like a dream. My DD is now 11 years old and I'm so thankful we had the choice to go private and it worked first time. Get the ball rolling!!

Thanks for the advice! I appreciate it :)