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Thread: Enodometriosis, Blocked Tube, and Miscarriage at first IVF Cycle... Help!

  1. #1
    Join Date
    Jun 2012
    Posts
    1

    Default Enodometriosis, Blocked Tube, and Miscarriage at first IVF Cycle... Help!

    Hi Dr. Saleh,

    I just turned 30, my husband and I have been TTC for 20+ months now. We did sperm analysis, everything looks good!
    I had an HSG (9/2011), no dye spilled from right tube, left tube looked good. Thought they saw a polyp on HSG in uterus so I had a pelvic ultrasound and they determined it was a fibroid (1.3cm). Had a D&C 12/16/11 to have fibroid removed.
    Did 3 cycles of Clomid and no luck. Went to an RE beginning of March she said I have enodmetriosis based on my symptoms I described (pain during intercourse, extreme pain during ovulation and horrible back cramps during days 1-3 of my period). Went for a second opinion, she said the same thing and both recommended IVF. At my appt I just happened to be on day 2 of my cylce so they started me on birth control in case I wanted to do IVF the next month. I proceeded with our first round of IVF in April. At retrieval I had 14 eggs, 13 fertilized, day 3 I had 6 embryos that were grade 1 but by day 5 I only had 2 grade 2 embryo's (nothing left to freeze). We transferred 2, I had a positive pregnancy test but at the 6 week ultrasound there was a sack and no fetus. I had a D&C the following day.
    My RE recommends that:
    1. I do not wait too long to do a second round, but long enough to be emotionally ready for round 2 and the possibility that this can happen again.
    2. I go on continuous Birth Control as soon as I get my period.
    3. I transfer on day 3, and consider transferring 3 eggs due to their poor quality
    4. And that they will try to reduce the follistem, as I was very sensitive to the meds. But they don't want to reduce too much because they need the eggs since I am not producing a lot of good ones.

    My questions for you:
    1. What do you think of their recommendations?
    2. Do you think I should go to a specialist regarding the endometriosis and consider the laparascopy? Will this help my egg quality improve?
    3. Do you think a diet, specifically tailored to reduce symptoms of endometriosis will help improve the quality of my eggs? (Diet example: no wheat or grains, no sugars, no red meat and no alcohol)
    4. Should I do the retrival, then let my body rest before doing the transfer to let my ovaries go back to a normal size?

    Thank you in advance for your opinion, I really appreciate it.

  2. #2
    Join Date
    Oct 2008
    Posts
    387

    Default

    My pleasure , please see below:

    My RE recommends that:
    1. I do not wait too long to do a second round, but long enough to be emotionally ready for round 2 and the possibility that this can happen again.

    A: There is really no reason to rush, especially since there was no testing done to rule out immune issues associated with endometriosis like NK assay.

    2. I go on continuous Birth Control as soon as I get my period.

    A: I do not see how this would affect outcome since you do not have ovulation issues but will help with pain

    3. I transfer on day 3, and consider transferring 3 eggs due to their poor quality

    A: The key is to wait until Day 5. That way, you can tell which embryo is really worth transfering. Day 3 is not enough. Also, I advise you get your AMH tested to make sure there is no ovarian reserve issue.

    4. And that they will try to reduce the follistem, as I was very sensitive to the meds. But they don't want to reduce too much because they need the eggs since I am not producing a lot of good ones.

    A: I would have to see the flow sheet. If you hyperstimulated, then the way the stim was handled could have affected the outcome and decreasing dosage would help. If you were given too low of a dose, then you need higher. The E levels and the graph would tell the story better.

    Also please note that D3 embryos are mostly egg-related and that sperm does no kick in until day 3. So losing embryos after D3 could be a sperm DNA issue (hidden issue). The SDI test would help determine.

    My questions for you:
    1. What do you think of their recommendations? A: see above
    2. Do you think I should go to a specialist regarding the endometriosis and consider the laparascopy? Will this help my egg quality improve?

    A: please avoid surgery at all cost until after delivery.

    3. Do you think a diet, specifically tailored to reduce symptoms of endometriosis will help improve the quality of my eggs? (Diet example: no wheat or grains, no sugars, no red meat and no alcohol)

    A: smoking cessation is only issue is applicable.

    4. Should I do the retrival, then let my body rest before doing the transfer to let my ovaries go back to a normal size?

    A: it takes 2-3 mo for the ovaries to rest and recruit a new batch of eggs. Do not rush at all. Waiting will pay off. Hope that helps. Please do not hesitate to contact me for any additional questions.

  3. #3
    Join Date
    Nov 2015
    Posts
    3

    Default

    There are a number of treatments available for endometriosis. They include surgery to remove the endo, pain medications, drugs that affect the hormonal system, herbal medicine of Fuyan Pill, and hysterectomy. Good luck with you!

  4. #4
    Join Date
    Oct 2008
    Posts
    387

    Default

    This is not a medical advise. I would consult oa fertility specialist that will treat the main problem whether fertility or pain.

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