Endo, Low ovarian reserve & Egg freezing

[Chaz09]

I'm 34, and have been recently diagnosed with stage 4 endometriosis. I was recommended to freeze my eggs before surgery. I have an endometrioma on my left over (3.4cm), and they worried that this may impact my ovarian tissue if removed. I had my AMH was tested it was very low (4.5pmol), so I sought private clinics to get my eggs frozen. Ultrasounds revealed my left ovary has one follicle, and my right ovary usually have between 1-5 follicles. However the right ovary is immobile, stuck behind my uterus and attached to my bowel, and was deemed inaccessible. Only my left ovary is accessible even with an abdominal retrival.

Option 1: My endo Dr would like to drain my endometrioma to help improve access and see if there is additional follicles on the left ovary. With an already diminished ovarian reserve, and using only half my reserve, I worry is it worth putting my body through all of that for little pay off. Recovery is 6 weeks.

Option 2: The dr that could offer me a full endo excision. This would hopefully detach my right ovary and make it accessible for egg retrival. The risk comes with how attached my right ovary is, the drs are concerned with the damage cutting away the ovary will cause. And may reduce my already low ovarian reserve.Also I won't be able to freeze my eggs until 3 months after the surgery. I've heard with DOR every month counts.

I'm so scared I'm going to make the wrong decision and destroy my chances of being a mum

Are you in a position to afford more than one cycle?

You could start a cycle without removing the endometrioma to see how you respond. Injecting FSH could spring more follicles into action even with the 3.4cm space-hogging in the ovary. Obviously medication isn't cheap but it could give you a sense of whether you need to drain it first to proceed with an actual egg collection. I think you probably do need to do a retrieval before the fuller surgery route of option 2.