Dilemma

[RobertsMother]

To cut a long story short: I lost my only son when he was 14 hours old in summer 2018, when I was 31 (he was born prematurely due to placenta previa). We started TTC as soon as possible after. Despite many symptom, no investigations were done until last summer (2019) and I was diagnosed with severe endometriosis last October (so bad that my kidney had swelled). I finally had my laparoscopy last month where several endometriomas were removed, many adhesions removed and one of my tubes was removed. Some adhesions between my uterus and bowel remain as it would have required a bowel resection to remove. During the surgery, they flushed my remaining fallopian tube with dye and only a small amount came out.

Our initial plan was to try naturally whilst waiting for IVF, just in case a miracle happened. Obviously IVF clinics are now closed and we've privately registered and had a consultation but can't go further ahead due to the corona.

My surgeon has now suggested that I should take Zoladex seeing as IVF is delayed. His main reason is to help my pain but I'm sure he is also thinking of delaying the re-growth of lesions. So now I have a conundrum, do I give up the hope of natural conception and hope the Zoladex works well enough to hold back the endometriosis and make IVF more likely to be successful? Or do I hope the growth of endometriosis will be slow so I can attempt natural conception and not jeopardise the potential success of IVF when the natural conception likely fails?

I will be 33 next month and everyone tells me I have lots of time but with the endometriosis and Coronavirus, I just feel like it's all going to be too late for me.

Wow that really is a dilemma my first response was don't take the drugs and hope nature takes it course seeing as I'm presuming you got pregnant naturally with your little boy (Sorry for your loss) however upon reading your post a second time I'm tempted to say take the drugs seeing as your endo sounds severe and your chances of conceiving naturally sound very slim given you've only got one obstructed tube. I think by taking the drugs you'll hopefully keep the endo at bay and give yourself a better shot at IVF and also reduce the pain you may experience over the coming months whilst you wait for your IVF to start. Good luck with whatever you decide but truth be told you might have to toss a coin because whatever decision you make I'm sure you'll question if it's the right one a million times over.

Flipping a coin sounds like it might be the way forward! I'm very torn because there are rumours of clinics potentially opening in the next couple of months so I might start Zoladex and then not be able to move forward with the IVF BUT then the rumours could be wrong. As it is, I have emailed my GP and had a missed call from them but can't get hold of them now to find out how to get the Zoladex.

I finally went for the Zoladex, then 2 days later was contacted to discuss medications and consenting to IVF! Unfortunately, things have gone wrong already. My scan showed a large cyst on my right ovary (doesn't appear to be an endometrioma, might be a Zoladex side effect). Then my AMH showed a sharp drop from 17 (May 2019) to 7. I expected a decrease due to the endometriomas and surgery but this is a bit sharp. A bit of Googling suggests that AMH levels are not reliable in patients taking Zoladex. I have emailed the clinic with the research I read to make sure they understand that Zoladex affects AMH levels.

Looks like they will wait for a few weeks to get a second cycle of Zoladex done before going ahead with the IVF, just with extra drugs and higher doses of drugs. They seem to think my age and the fact I had my son are both the most important factors to concentrate on.

Sorry for your loss of your son. That must have been very hard :(

I would take the z as to help conceive naturally or ivf the inside of your womb needs to be in good shape iyswim

Yes you did get preg and now you have one tube that may be semi blocked so narrows your chances at naturally falling

Tho doesn’t mean you can’t

You are young and Tho doesn’t seen it you do have time eep with ivf

I was Almost 44 And after 5ivf when gave birth

And had one blocked tube tho the other fine and tech no reason why I shouldn’t get preg naturally but never did in 10yrs ttc

Glad you took the z and hope you get some shrinkage of cysts soon

Thank you for replying. I am going to continue with the Zoladex probably for another month. The cyst may shrink as it is possibly an initial side effect of the Zoladex. And I do think that Zoladex suppresses AMH so the result appears lower than it really is.

Hopefully, my age means that any eggs harvested are more likely to be of a good quality so I don't think I'm out by any means. And we have a deal where we get 2 years of unlimited IVF cycles so we can really go for it.

Wow. That’s some deal

They didn’t really do those when I did ivf

How much is unlimited if you don’t mind me asking

Well you have to have your records evaluated, then you pay a certain amount (depending on fresh/frozen, ICSI, age- around £15k). Then you get as many IVF cycles as you can fit in 2 years. You just have to pay for medication. We figured that it would take quite a few cycles possibly so best to try to fix the cost.

Oh so drugs on top. Think mine was 1500 on one cycle

So still have to pay on top

But seems a good deal. Good luck

Oh yeah, it's still costing an arm and a leg but will allow us more cycles than if we pay as we go. With the endometriosis and low AMH, I am thinking we might need more.

Has anyone else driven themselves crazy reading the conflicting research on AMH? I am holding onto the study I read which says that, under 36, AMH levels don't seem to determine live birth rate from IVF but I know a lot of studies say otherwise. Google is driving me crazy!

Don't know anything about zoladex but Just to say that I'm a few years older than you and pregnant having lost a tube to a previous ectopic, had endometrioma removed along with many other lesions in 2018, and with an amh of 7 following surgery. We had ivf but we had some male factor problems too. Try not to worry too much, your problems are certainly surmountable.

Don't know anything about zoladex but Just to say that I'm a few years older than you and pregnant having lost a tube to a previous ectopic, had endometrioma removed along with many other lesions in 2018, and with an amh of 7 following surgery. We had ivf but we had some male factor problems too. Try not to worry too much, your problems are certainly surmountable.

I went on back to back packets of a progesterone only pill with no breaks for a bleed for about 6 months before surgery and 4 months after, was meant to stop the Endo coming back, obviously you can't conceive on that but might be another more temporary option?

Thank you so much, that gives me a lot of hope. I think I've been through so much that I tend to believe in the worst case scenario.