endometriosis cysts (endometriomas) on u/s?

[Anonymous]

So, before starting to TTC, I got a pelvic exam with an ultrasound that showed a couple of endometriomas, one of which was on my ovary. I never suspected that I had endometriosis, and didn't know that my moderately painful periods (which were fine with Advil) pointed to this. From what I've read online, it seems like I have moderate or severe endometriosis because I have endometriomas, which will make TTC more difficult even after surgery to remove the endometriosis, and that IVF is often needed. I need to discuss things more with my doctor, of course, but does this seem accurate to those of you who have had endometriosis? Any links to reliable info would be appreciated. Thanks!

[Anonymous]

I have endometriosis - when diagnosed I had 1 large cyst in each ovary. My doctor told me after the U/S that he couldn't be sure the cysts were endometriosis... That they can come and go... And that I only needed to address them if they grew too much or caused a lot of pain. Both things happened, so he removed one cyst and drained the other (in order to reduce damage to my ovary). Fortunately he didn't find anything else.

I conceived one child naturally about a year before all of this. The doctor thinks I probably had the cysts before I got pregnant.

Fast forward, we've been ttc #2 for a year. IUIs have failed us and we're going to IVF. However, I think the IUIs didn't work because of issues that were found with DH's sperm. I think endo becomes a bigger culprit when it 1) compromises the ovaries, and/or 2) has spread and, say, blocked the fallopian tubes. One of my ovaries was somewhat compromised after the surgery - it's smaller now and produces much less eggs when on the ovulation stimulants.

It all depends on so many different factors. If your doctor is concerned he or she may ask that you hold off TTC until a laparoscopy can be performed... Which will give you a much clearer picture of your situation.

[Anonymous]

I have Stage 3 Endo, diagnosed via LAP. The only way you can determine if it IS actually Endo is to have a LAP. Yes, it can make it incredibly difficult to conceive. We TTC for 5 yrs. and did 3 IUI's all with BFN's. We finally conceived via IVF. I wish that I wouldn't have wasted time and money on the IUI's and went straight to IVF. I know that everyone has a different take on Endo and the proper treatment protocol. I saw SG and they don't have any RE's that specialize in Endo, which was diasppointing.

I also had 2 endometriomas on each of my ovaries. I had them excised (cut off, not burnt off which is supposedly the preferred way of removal) and after the fertility meds, they came right back from the FSH stimulation.

[Anonymous]

Thanks for the messages.

06:38, I'm glad IVF worked for you.

My doc wants to do another ultrasound, this time during my period, and then a lap to remove the endo (assuming the lap confirms the ultrasounds). I guess I shouldn't be as worried as I am since I don't even have a definite diagnosis yet.

[Anonymous]

I had stage 4 endo with endometriomas on both ovaries that were the size of baking potatoes. I had an open surgery to remove them and the endo because it was so severe....out of work for 6 weeks.

I did need to do IVF because my tubes were blocked due to the scarring. My FSH was slightly elevated because of the damage to my ovaries from the surgery and endometriomas so I required mega doses of stims to produce adequate eggs. Both of my IVF cycles were successful and I have two little boys! I went to SG and Dr. Levy was my primary doc.

I also had a uterine abnormality that Dr. Levy sugically corrected before my first IVF cycle....carried both babies to term.

[Anonymous]

Another endo sufferer who needed IVF -I also had endometriomas....if you have those, they typically are indicative of the endo being present elsewhere, as well.

I would recommend a consult with an RE or two. This is often over an OB/GYN's head. (The GYN may see someone with these occasionally. An experienced RE is typically far more familiar with endo complications (and will typically be a more practiced surgeon). I wish I hadn't let my OB/GYN dither around with these so long. I have known several women with luck with Rifka at CFA or Widra at SG.

[Anonymous]

OP here. Thanks for the suggestions. If you did IVF, at what point did you decide to try IVF?

[Anonymous]

After a laparotomy. I had it everywhere, and I knew the statistics were against a Stage IV endo sufferer conceiving naturally or through IUI. I had one cancelled cycle due to poor response, and then my successful cycle.

To me, it's a big leap at first, and then people accept it and wish they had done it sooner.

[Anonymous]

Anonymous wrote:OP here. Thanks for the suggestions. If you did IVF, at what point did you decide to try IVF?

15:18 here......I knew that I would most likely need IVF after getting my surgery report with the stage 4 diagnosis. I literally went on birth control pills immiediately after the surgery to help prevent any endo recurrence and stayed on them until I was ready for a family. At that point I made an appointment with the RE and they did an HSG as well as other tests to determine where I stood. The HSG showed blocked tubes so I went straight to IVF.

I felt this was for the best because I didn't have to go through multiple failed cycles before resorting to IVF. I also didn't run the risk of the endo recurring from being off of birth control for an extended period of time while trying to conceive naturally.

It can be pretty cut and dry whether or not you need IVF if your HSG shows blocked tubes. IF the HSG shows blockage you just go straight to IVF. If the HSG shows your tubes are open then you can certainly try IUI's or naturally conceiving first but I wouldn't waste my time with that unless you have proof that your tubes are healthy and open.

[Anonymous]

Anonymous wrote:

Anonymous wrote:OP here. Thanks for the suggestions. If you did IVF, at what point did you decide to try IVF?

15:18 here......I knew that I would most likely need IVF after getting my surgery report with the stage 4 diagnosis. I literally went on birth control pills immiediately after the surgery to help prevent any endo recurrence and stayed on them until I was ready for a family. At that point I made an appointment with the RE and they did an HSG as well as other tests to determine where I stood. The HSG showed blocked tubes so I went straight to IVF.

I felt this was for the best because I didn't have to go through multiple failed cycles before resorting to IVF. I also didn't run the risk of the endo recurring from being off of birth control for an extended period of time while trying to conceive naturally.

It can be pretty cut and dry whether or not you need IVF if your HSG shows blocked tubes. IF the HSG shows blockage you just go straight to IVF. If the HSG shows your tubes are open then you can certainly try IUI's or naturally conceiving first but I wouldn't waste my time with that unless you have proof that your tubes are healthy and open.

I also wanted to mention that just because your tubes are open does not mean that the endo hasn't caused other issues that would result in infertility so you still might end up with IVF after all is said and done.

My good friend has conceived 3 kids naturally after a laparscopy and subsequent open surgery for stage 3 endo....

[Anonymous]

Anonymous wrote:OP here. Thanks for the suggestions. If you did IVF, at what point did you decide to try IVF?

(Pgcy met.)
6:38 here. I had a LAP to remove my Endo in May of 2009. I did 3 IUI cycles, 2 with Clomid and one with Gonal-F which all produced more cysts post cycle and were subsequent BFN's. In Oct. 2009 I bit the bullet, shelled out the $20K for Shady Grove's Shared Risk program and did my first fresh IVF cycle in Nov. 2009. I wish I hadn't wasted the $7k on the IUI's and went straight to IVF. But for some, it's hard to take that leap.

I hope that you have success soon. I will say that just because you have the endo removed doesn't necessarily mean it will stay gone forever. Mine has returned (post pregnancy) and now I'm dealing with Endo hell all over again.