FET and age when infertility is due to endometriosis
![[Post New]](/jforum/templates/default/images/icon_minipost_new.gif){kind=icon}
Anonymous
|
I'm wondering whether anyone has any insight or thoughts on whether chances of success with an FET are likely to decrease with increased maternal age when endometriosis is a factor.
My infertility is due to severe endo, and I have significant scarring/adhesions in my pelvic cavity. The endo was diagnosed during a laparotomy for a ruptured ectopic, and my OB cleaned up some of the scar tissue at the time (I think he mostly worked to free up the tube without the ectopic). About 6 months after that I did my first (and only) fresh IVF cycle, at age 33.5, and ended up with seven 5-day blasts. We went through four of them to end up with our son when I was 34.5. He was born by emergency c-section, and after the surgery my OB told me that my bowel is fused to my pelvic wall - but couldn't say whether that scar tissue was due to the endo or a result of my earlier surgery. Regardless, it seems possible that since the c-section I may have developed additional scar tissue, due either to the endo or the surgery. DH and I know that we would like to try for another baby with our three remaining frozen blasts. I am pretty sure, though not 100% certain, that if we exhausted those embryos we would not continue our efforts by starting again with another fresh IVF. So my question is: will our chances of success be lower if we wait a bit to begin trying with those frozen embryos? In an ideal world, I'd like to wait until our baby (9 months now) is about 2.5 to start an FET. How likely is it that I'd be decreasing our chances of success by waiting that long? I am on BCP (not mini-pill), so the progression of the endo should be halted or slowed... But obviously, if our chances of success will be lower if we wait, then I don't want to wait too long. I know this question is probably really one for my OB and RE, and I do plan to speak with my OB about this at my annual exam in a few months, but I just wondered if anyone here has any insight based on their own experience. Thanks so much. |
Anonymous
| I think it should probably be OK, but honestly, I would suggest having another lap before you do your second transfer. BCP or no, with endo as severe as yours I'm betting it will grow. You don't want to waste any of your remaining embryos by transferring them into anything less than an optimal environment. |
Anonymous
|
I don't have any specific data on how much the success rates would be affected by delaying, but I did go through something similar.
My endo wasn't quite that bad, but we did wait until #1 was 2.5 to do our FET. About 6 mo prior we met with RE and I had some uterine scar tissue (from c/s?) so I had a hysteroscopy before the FET. I BF until 2 (why I waited) so my cycles were lighter. Fortunately the FET worked because I don't think we were going to do another fresh. It a very tough decision - good luck with whatever timing you decide, OP! |
Anonymous
^ and I did have a lap (stage III endo) right before our successful IVF cycle, but not again before the FET. I would definitely ask the RE about having another lap before the FET like the PP suggested. A good question. |
Anonymous
|
PPs, thanks SO much for your feedback. I am a bad endo patient, clearly, as I had not thought at all about a lap before trying again! I guess because of the way my endo was diagnosed and the fact that we moved immediately on to IVF after that surgery... so there was never discussion of a corrective lap at any point the last time I was going through this. I will definitely talk to my OB about that! I am also worried about possible uterine scarring... when I was at my OBs at 10 weeks postpartum my uterus was still "inflamed" (tender, swollen on palpitation), so I know that's something that will need a look too.
Thanks again very much, and PP - so glad your FET for #2 worked for you!!! |
Anonymous
| Definitely ask about another lap. I had stage IV and had 2 laps at various points. Several miscarriages too. We have 2 healthy children, now 14 and almost 12. It can work. Optimal environment is key, great diet too prior to trying FET. |
Anonymous
| OP, you might also talk to your OB/RE about the pros and cons of a 3 month course of Lupron Depot prior to transfer. There is some evidence that this can improve implantation rates in women with endo. I did this prior to conceiving both of my children and following many losses/failures. |
Anonymous
| Good luck, OP! Hope your ute' is feeling better soon! |
Anonymous
OP, I would consult with your RE about a lap before FET. The best one you can find, one who is up on endo. The OB might not have the most current approach. And like another PP mentioned, an RE might suggest something like the Lupron Depot course... |
Anonymous
| OP, if your endo is truly severe, I would seriously consider both a lap AND a 3 month course of Lupron before your transfer. And I agree about consulting a good RE, who is experienced with endo. |
Anonymous
Agree. If you do a lap, get the best surgeon possible, NOT your ob. |
Anonymous
|
Thanks again, PPs. These are things I really hadn't thought about, I think in part because of the way things went last time. I'm glad I asked a question here!
Does anyone have a recommendation for a surgeon who specializes in endo? Or is that a question I should ask my RE? I worked with Dr. Sagoskin at the SG Rockville office for my first IVF attempts, and felt comfortable with the treatment I received and his approach to my care. Is there another RE, though, that I should look into? Are there any RE's in the area who have specialized knowledge/experience with endo? Thanks again for all of feedback. I really appreciate it. |