Newly diagnosed Endo and IUI

Im 35 trying to have a baby.  On my first IUI I became pregnant, had low progesterone used suppositories, but still miscarried.  This was in May and I waited to try again, beginning in July my cycle came with horrible pain, so bad I went to the hospital. they ruled it as unexplainable pain even after a cat scan.  In August I decided to try IUI again, on my first visit my doctor saw the endo on an ultrasound.  He told me that it was just my make up and I have had it all my life it has just now acting up, maybe the bc pill kept it at bay and that we would proceed.  That IUI was unsuccessful.  I have done lots of research and I now know that endo can complicate my chances of getting pregnant.  I dont understand that it waited till almost 30 yrs and a miscarriage to cause problems.  Im now at a stand still and don't know what to do!  I dont know if I should just give up, trust my doctor and try again or see about having something done about the endo first!  Could this be any side effects from my past treatments or meds?

[Elaine Brown, MD]

Hi!
I am a little confused because endometriosis is not normally visible on ultrasound.  A laparoscopy is almost always necessary.  It certainly is possible that you do indeed have endometriosis, and that the symptoms were blunted by the oral contraceptives.
Many women who have been long term OC users find their natural periods quite heavy, and uncomfortable.  Endometriosis can contribute to infertility, and can increase the risk of miscarriage.  Studies are mixed as to whether treatment by laser or other surgery improves conception rates.   Certainly, if the endometriosis has affected the tubes, removal of blockage or adhesions improves fertility.

Because you were able to successfully conceive once, there is a good chance that you will be able to do so again--and most likely with a better result in the next pregnancy.

If you were my patient I would base my decision to operate based on how painful your cycles were--surgery does improve pain.  Also, if you had a second miscarriage, I would strongly consider surgery too.

Hope this helps!
Dr B

[trying43]

I know the first cycle after I had mine removed, we did medication only and got pg. first try, I am now 18w5d.  In my case it was definately a problem because we tried for over a year.  Good luck to you.