Laproscopy for endometriosis hopefully next month.

[Sarahdaydreamer1234]

After all our tests including HyCoSy coming back as normal, due to painful periods and stabbing pains in the rectum during period and painful sex, I have been referred for a diagnostic laproscopy for suspected Endo. My tubes are clear, no cysts and I ovulate according to scans, blood tests and kits so I am just wondering if anyone had Endo in other ares which wouldn't obviously affect fertility such as bowel or pouch of Douglas and then successfully got pregnant after removal? Or also I would like to hear if people didn't and went on to IVF? I'm just unsure really if there's any point getting my hopes up that removal will help as I can be reffered for IVF now but I plan on waiting for a few months to see what happens after the Lap. Also my AMH IS 12.96 and I'm 30 but AFC is 22 so I think my ovarian reserve is hopefully normal.

I have endo in the same places (bowel etc with ovaries and tubes clear) and conceived my son with the help of Clomid (I don't ovulate without it). I have just had another laparoscopy as we are struggling to conceive number 2 - the consultant was certainly hopeful that removing endo and adhesions should help so I wouldn't rule it out. Good luck!

@bec1985 oh good luck! Thank you that does sounds good that he was hopeful! Did you need the endo removed to concieve your son?

@Sarahdaydreamer1234 I had two laparoscopies in 2015/2016 and then was on the pill back to back until I wanted to conceive. Because of the endo I didn't have to wait very long for a referral for fertility treatment and then conceived in 2017. So it is hard to say but it may well be that the laparoscopies put me in a good position to conceive!

@bec1985 sounds like they possibly did and the pill kept it at bay.. that was good the clomid worked for you! All the best for baby no 2 😁

I had three IVF fails then had a lap (endo was confirmed and excised) and my fourth IVF was then successful.

Fertility docs think laps aren't necessarily more successful than IVF. Gynaecologists disagree and think the endo should be treated.

I don't know if the surgery made our last IVF transfer successful or not but for me it was a positive outcome.

Good luck!

@fingersXssd83 congrats on your successful IVF. It certainly can't hurt to get it removed I suppose. Were you having IVF for unexplained infertility? Did you have the endometriosis all over or did they tell you?

Thank you! Yes, I was unexplained before but I suspected I had endo (the GP and NHS fertility clinic didn't ask/take it seriously).

The lap revealed endo in lots of places - one blocked tube, on ovary, pouch of Douglas, urethra, tiny bit on bowel. So, it was extensive but not very deep. Didn't get given a grade but I'd suspect 2-3.

As well as mechanically causing issues with fertility such as a blocked tube, endo can cause issues with inflammation and at a cellular level that affects egg quality. I

f you're going to have IVF it would be good to know why you are struggling to conceive so they can put you on the correct protocol as some meds can make endo worse (I was on this for my first round)...

Good luck with it all! xx

I had laparoscopy and dye, they found no blockages, no endo in tubes or ovaries, but some in bowel, bladder and pouch of Douglas, they removed just the endo in pouch of Douglas and said they didn't believe this would change my TTC journey at all, which I thought was a bit negative and in hindsight I think they were just trying not to get my hopes up.
I got pregnant 2 weeks later! I definitely think it helped. Whether that's having the dye flushed through or the endo removed I don't know, but so many people have a good outcome from a lap & dye that it can't all be a coincidence I don't think. Good luck to you!!

@fingersXssd83 thank you for explaining that makes sense then! And yes it will be good to know what's going on either way.

@starshipcandy that's great it happened for you after the lap and dye. I'm not getting dye as I've already had a Hycosy. It was only last month so who knows it could work either. Although they said it went though super quick and had to use 1ml instead of 5ml so there was definately no debris of any kind in their opinion but who knows.

Thank you for all you responses. I'm just so nervous as after laproscopy if unsuccessful 6 months after this it will be IVF and I'm just not ready to give up on conceiving naturally yet, which is so strange as I never realised that was a thing I cared about I always saw IVF as not an issue in that regard.

Also do any of you think it's worth pushing for a hysterocopy during the laproscopy? My fertility consultant didn't think so as she thinks scans would have shown up and polyps, scarring etc. Usually I think it would be no harm but she actually thinks there is small risks with this so best not. I just want to make sure something isn't missed and its the only test really that I won't be having.

Just bumping this question about whether it's worth getting a hysteroscopy? Ant thoughts much appreciated x

I would be bloody cross at them for merely suggesting a diagnostic lap.

Do not settle for just a diagnostic lap because that will likely entail more surgery going forward. If they find endo along with any polyps it needs to be lasered out there and then, not in a subsequent lap procedure. You do not want any more surgery in this area than is absolutely necessary.

FWIW your symptoms are highly suggestive of endometriosis to me, particularly the deep pain during sex.

As you're having a lap I would dispense with the hysteroscopy.

You should also be given an appointment a week or so post op to discuss the findings. You do not want to be given a lot of information re the lap findings when you are in the recovery room, apart from anything else its poor practice.

@attilathemeerkat thank you they did say they would remove any endo they could so hopefully I don't need further surgery! So do u not think the hysteroscopy could see something else?

TBH a hysteroscopy is not really going to add to what a lap could do here. Also if a hysteroscopy was at all suggested, its better to have that procedure done under GA.

Do let us know how you get on.

Make sure you get any endo excised not lazered at a BGSE accredited centre

@fingersXssd83 it's the Liverpool women's and the lady is an endo expert I think but will ask that they excise over laser! Thanks

@attilathemeerkat OK thanks I suppose I just thought while I'm under GA for lap they could do that too to look inside my womb just on the off chance soemthing in there is stopping me getting pregnant.. I just want to cover all I can before starting the IVF route if I have to.. But if they can see in my womb during the lap then I suppose there is no point

@Sarahdaydreamer1234 I had a laparoscopy where they found and removed endometriosis on my bladder, uterus and I had a small endometrioma causing my left ovary to stick down. I was sure they would find it on my bowel as painful bowel movements around my period were my biggest symptom. They said none of this would cause a physical barrier to conception but endometriosis is a poorly understood disease and it is not uncommon to have endo like mine that seems to affect fertility but they don't really understand why. I was hopeful that this would solve my fertility issue but sadly not. I gave it 6-7 months and then started the ivf process. My 3rd round was successful. Best of luck to you, hopefully the lap will do the trick-it does for many women. X

@spyroc ah thanks so much.. Im delighted you got your happy ending - Its great to hear a positive ivf story! I hope the lap does something as I have been pregnant twice but sadly miscarried but now can't get pregnant for over 18 months so it's just so frustrating and I haven't wrapped my head around IVF yet to be honest the emotional aspect terrifies me. .Did the docs feel endo affected ur IVF - obvs not really when you were successful!! My Amh is a bit low for my age and thinking that could be endo related.

@Sarahdaydreamer1234 my AMH was very low for my age at 5 aged 31 (uk unit of measurement). There is some suggestion that aspiration/removal of endometriomas can affect ovarian reserve so as you know your AMH is already low it's worth discussing the risk vs benefit of treating those if found. Conversely large endometriomas can make access to the ovary during ivf difficult. I sometimes wander whether the survey made my reserve worse but I'll never know tbh I suspect not as my FSH was already elevated but who knows! I do know that my pain levels decreased. In my case, I don't make very "good quality embryos" my consultant says the low reserve and likely egg quality issue are probably linked to endo but is honest in saying they can't say for sure. My own research backs this. I really don't know for certain the endometriosis is the sole cause of my infertility but it most likely plays apart. I would have thought if low reserve and egg quality were the issue that I'd have at least experienced a mc in 2 years of trying. Sadly endometriosis is still a bit of a mystery. Hopefully you will not get to IVF-Google post laparoscopy conception-there really is lots of reason to be optimistic. It is sensible your considering the wider picture though. X

Survey should be surgery 🤦🏻‍♀️

@spyrpoC thank you so much! that is certainly something to consider regarding the surgery causing egg reserve to drop. Further it was strange as my AFC was so high (25 i think) It's a minefield isnt it..I will make sure and report back on this post post surgery xxx

@Sarahdaydreamer1234, good luck on the surgery!

Sorry this doesn't relate to the original question directly, but finding endo threads is a little tough. How did you get them to look at AMH and AFC, as well as HSG before the diagnostic lap? I'm in a similar situation, but only had an ultrasound (showing a suspected endometrioma), FSH (7.8), and Day 21 test. I asked for the HSG desperate to the laparoscopy, but they aren't allowing this.

@jng18 my fertility clinic did all the tests, the laproscopy is actually through general Gynae for me. I think only some clinics do the Amh test. I don't know why they won't do the Hycosy maybe they are doing a dye test with you laproscopy and don't see the point? They might have counted ur foliciles in ur ultrasound and just not told you? What age are you if you don't mind me asking? Have you been trying long?

@Sarahdaydreamer1234

Thanks for your help.

I'm 32 years old, DH and I have been trying for 2 years (cycle 24 starts next week) with one very early MC (4 weeks). The ultrasound was given in response to me mentioning my period pain and painful urination and bowel movements. STI checks were all clear, day 21 was fine and FSH at 7.8. The ultrasound found the suspected endometrioma (on or near an ovary), no mention was given of AFC being measured.

I'm just hoping to not go through the laparoscopy, (which I have read can damage ovaries in removing cysts/growths) try for some more time then find out something like AMH was a mess all along. I'm grateful that my period pain isn't (often) extreme, so I think I could do without the lap if endo isn't affecting my fertility.