ENDO/TTC After Femara/Aygestin Treatment- PLEASE HELP!

[JennViv]

Hey Ladies!
I just wanted some opinions on this. Back in August, my doctor did a laporoscopy on me. He found my endo to be very severe and my left tube/ovary were fused completely. My bowel was fused to my uterus and my right tube was 25% fused to my uterus. Meaning-I had about a 75% chance at getting pregnant on my right side.
My doctor decided not to remove or operate on the endo because he feared it would be come worse with the scarring from the healing. He put me on Femara/Aygestin treatment for 3 months. He stated at that point, we had a few options:
-Do 3 more months of Femara/IUI (he also said "maybe getting pregnant on your own")
-IVF
-Surgery to fix the bowel/TRY to fix some endo (he said he's more comfortable referring me to another surgeon (his collegue) to do the actual surgery - at the same office)

SO, my question is, what would you all do? I've read good results on the continuous Femara treatment, but I don't know if i'm better off moving on to surgery and THEN TTC or would you all TTC for another 3 months and THEN decide surgery or not?
I know it's kind of a weird question because there's not many studies I can find out there with this treatment to know the success rate? PLEASE HELP!

[bny807]

Hey girls!  well good luck to both of you and empty i'm praying that this IVF does the trick! keep me updated!!!!! : )
as far as the femara helping and its relation to the lap.. it seems most of the studies were afer lap's but i would think if it helps the endo it helps it either way the same.. that surgeyr wouldn't make it better or worse ya know.. but who knows!!!
   i know what you maen about the surgery..my RE wants us to do another lap this month, but i'm giong ahead with two more IUI's before that, scar tissue can lead to bowel obstructions from scar tissue etc.. so i also am trying to limit it.. ugh! what a pain it all is!!!
GOOD LUCK TO BOTH OF YOU, yall are in my thoughts and prayer and keep me updated throughout this hopefully short lived journey ending in a beautiful baby in our arms! :)

[empty]

Hi Guys

I am a chronic endo sufferer...a classic choc cyst girl :)

I have gone through 3 failed IUIs and have decided to go onto IVF in the next month. My take on endo sufferers is definately to do IVF. My doc has given me 9 months to get pregnant after my lap endo cleanup 2 months ago.  I have decided not to delay IVF as it will be just a matter of time before I have to do another lap cleanup.

Good luck with your decision.

[JennViv]

don't know that i'm brave enough to risk IVF. our insurance covers ZERO towards it =(
I work at the insurance company and can't even convince them to help financially in the least-terrible huh?
I HATE HATE HATE surgery & my RE knows it so much that on the day of the lap he said "wow i'm suprised you showed up-thought u might not" lol I'm really fearful of the excision surgery because right now my endo is "manageable" and i have heard awful things due to scar tissue build up from surgeries like that. I'm not so sure i want to risk that (don't get me wrong i'd give my right arm for a baby - but what is the use in making myself sick the rest of my life from complications!!).
I can't figure out from the studies if they have shown femara getting rid of/reducing endo in patients who had nothing removed before the meds....or is it only useful in preventing further endo AFTER a lap has removed the endo there. Do you know?

Thanks for the info though. I really hope that your next iui results in a BFP!!! Wouldn't that be wonderful! I'll keep my fingers and toes crossed for you =)

[bny807]

I know what you mean, i've lost track of how many times we've done IUI's as well!!   well we have combined femara each cycle with my follistim.. the first two cycles did just femara, but each cycle my estrogen is lower than it should be which is caused by the femara, and good for endo patients since estrogen is the catalyst for the endo, so he is a big fan using femara and combining it with injectables in endo patients.. we've talked about the femara for suppression, but since we are at least getting pregnant we havne' t talked about it too seriously...with the excision surgery, apparently adhesions aren't really as big of an issue with that.. but it can be a big surgery not to mention if you don't live near a specialist you have to add travel time and costs.. humm.. not sure what i'd do in your situation.. since i hate the downtime and invasivness of surgery, i lean more towards taking a chance without surgery.. you could always try an IVF right off the bat while you have the maximum benefits from the supression from the femara.. without surgery first.. my RE was going to do IVF without surgery for me since it takes out a lot of the endo problems- the fimbrae on the fallopian tube if its stiff from the endo and not picking up the ovulating eggs it takes away that problem also the hostile environment of the endo for the ovulating egg.. so if you have the finances and are brave enough that might be a good option.. but who knows, there is no "right" answer, i hate all this chance and if's and maybes etc!
  unfortuantely they do think that endo does increase chance of miscarriage.. so thats no fun.. however for many many people it doesn't seem to be a problem at all!
  GOOD LUCK, let me knwo what you decide!! i wish this stuff could just be easy! ha!

[JennViv]

Wow thanks so much for responding! We tried I *think* (i lost track - terrible huh?) 7 or 8 iui's...using clomid and injectibles. However, we had no idea that my left side was useless, & I believe i only ovulated once or twice on my "good" side. It never took. I'm glad you responded, because I really wasn't sure if it was true or not that the endo would become worse if they tried to "remove" it.
The dr. stated that he thinks we'd only try approximately 3 more iui's (i'm assuming only if i Ovulate on the good side).
Has your RE ever suggested the femara? Some people were surprised I was put on it. I am really really glad to hear that you got a BFP even though you had the severe endo (gives me some sort of hope). Is it true that the endo can cause a miscarriage? That is my next fear.

[bny807]

ugh, i'm so sorry your going through this!! i have severe endo as well, and your right there are very few studies that i can find about the femara treatment.. though what i did find shows great hope! I am in a similar situation as you.. we were ttc for 8 months and i had premenstrual spotting and we did an ultrasound and found an endometrioma 7.5cm on my left side.. it had demolished most of my left ovary.. so my obgyn at the time did surgery and removed the endometrioma, but didnt' touch any of the other endo either.. she told my dh that i was the worst case she had ever seen! ugh! not something you want to be told! anyhow  she didn't "clean up" anything except that left ovary which is now not functioning, and they think also that its now it has lots of scar tissuearound that area.. anyhow.. we were given very similar options.. they wanted us to do lupron... but looking at the studies showed no help with fertility unlike the femara, so i rushed to an RE
  he also thought we'd have to do IVF, as we found i have mild pcos, and also severe male factor ahhh! well he said IUI can work so he wanted to give it a try.. so we did two without success and discovered i also had LUFS (from the endo and pcos most likely ughhh!) during my IVF consult since AF had already started he wanted me to try one more IUI (it would be our third) and "test" out injectables before IVF.. well we got pregnant! we were SHOCKED! unfortuantely miscarried.. we then did two more IUI's and got preg again, but miscarried again.. soooo in a couple of weeks we'll be back to IUI>. soo personally i think that IUI is worth a try.. it might not work, but its so much cheaper and i think less of an emotional, financial and time investment than IVF so its worth a try.
    My dr now wants me to do another surgery so he can now "clean up " the endo, but i think i'm going to try IUI one or two more times before that.. i hate the idea of another invasive surgery.. but it may help though..    also if your considering surgery - excision surgery seems to be the route to go (though i'm not sure i'll take the time to do it though) here is a DR who is supposed to be amazing - there are very few in the country that do this http://www.gynecosurgery.com/dr_kanayama.htm    GOOD LUCK Your in my prayers and thoughts, let me know if you need anything!!

[JennViv]

I should also add, the one side that was 75% "free" was successful in the dye going through. The other side was NOT successful (the side that's completely fused). 2 Years ago with my HSG, both sides were completely clear. My guess is the endo progressed ALOT since 2 years ago, so that's why I'm not sure what to do.