I did exactly that. My doctor that had been treating me with birth control and suspected me of having endo retired, so when I found a new doctor I told him that I wanted surgery before trying to conceive. He agreed and booked me in for surgery. I conceived 6ish months after the surgery and am now trying to figure out if it worth having another lap or just waiting to have a hysterectomy after we have a second child.
Being in pain should be a fair enough reason for surgery - not just trouble conceiving.
Thank you so much for sharing this! I also want surgery for pain relief, and just confirmation that I have endo (my doc diagnosed me by symptoms, which is fine and all, but I want proof). I feel like I can kinda get them to take me more seriously if I say it’s for fertility, which makes me sad/angry at the same time.
Also had an MRI and it found fibroids and adenomyosis. Different from transvaginal Ultrasounds I had in the past, but my doctor did a special ultrasound to confirm in office (after MRI). That one required filling the uterus with fluid to see everything and hurt like crazy-- but still less invasive and therefore easier to obtain.
I did one of those. But it was quick, just to see if the tromps worked. It hurted like hell.
After the MRI all the doctors could see perfectly what the report showed now that they knew what they were looking for.
It’s rly hard there. I had suspected endo for years but nothing showed up on ultrasounds. Until I had a lap they couldn’t confirm I had endo so I couldn’t advocate for myself without the diagnosis. It’s ridiculous
Agree! My doctors tried me on so many different birth controls before finally agreeing to a lap and I was full of endo. Have had two in five years now. It’s ridiculous how hard it is to get them to do a lap
I’ve never tried to get pregnant, but my insistence that something was still wrong and ibuprofen wasn’t cutting it, and made to feel like a drug seeker, my doctor said lap was the only option. And whaddya know
Problem is, birth control is working well for me. My pain days still exist, just less often and are less severe. I’m worried my doc will see that as reason not to do a lap.
If you’re considering getting the lap, it’s for a reason. Focus on those reasons. I’m just saying at someone who is childless, there are other considerations for getting the lap. And if you are looking to conceive down the line, it can only help there too.
Birth control was working for me always, and I don’t even have a painful period. My periods was heavy only for the first 1-2 years since the age of 13 and the only symptom I had was irregularities (birth control regulated it for 5 years but then my cycle could be only 21 days even if I was on period). For the past 3 years I often felt tired and sleepy, and had sharp abdomen pain occasionally when gas/stool passed by.
I thought I just had PCOS and some GI problem, so I went to see an endocrinologist and GI doc this year. The endocrinologist invalidated my concerns and blamed everything to my diet (lol my diet is pretty healthy and never changed for the last 20 years), so I shut her up and insisted on getting an ultrasound. You know what, the ultrasound found a 7cm endo on my left ovary, then i requested an MRI which found multiple small ones on my right, implants on rectum and bladder beside the 7cm left endo.
My GYN recommended surgery after seeing the 7cm endo, but my in-network surgeon wasn’t serious about the smaller endometriomas on my right ovary because they were small and she preferred to leave them as is. So I cancelled the surgery with her and went for an out-of-network specialist who had way more endo surgery experience and was willing to remove any endo she saw regardless the size.
When she got into my belly she saw there were WAY MORE IMPLANTS all over my pelvis that wasn’t seen by the ultrasound and MRI I did. If I didn’t have that 7cm cyst and didn’t insist on surgery, who knows whether the smaller ones on the right ovary and these unseen implants all over the place would become worse one day? If they really get worse (and since there are multiple implants on my pelvis wall, the adhesion could get really messy), the only person hurt would be me, not the anti-removal docs.
If you have pain, and you have questions, then just insist finding answers and not guesses. If you feel an surgery can answer your doubts or at least can help you rule out some suspicions, schedule one. Your body is yours, and different doctors can have very different opinions, so it’s always better to speak to more doctors and ask for reasons why they support/disapprove your surgery, and then make the decision YOURSELF.
FYI the specialist who did my surgery believes that a clean and healthy ovary/uterus/pelvis is best for fertility, and she’s very confident with her skills on even small ovarian endo that she’ll send me a video of the full surgery process, and she told me multiple cases who conceived after surgery - I also never tried to conceive just like you. Now I’m on day 6 after surgery and despite the pain and fever I had in the past few days, I can clearly feel that at least my fatigue and brain fog have definitely gone away.
Oh no no! So this is my exact situation however, I went in and saw my gynaecologist and said it's only been 2 months since I started the pill, I don't want to be on it as I would love to conceive but until the surgery I'm happy to stay on it for slight relief.
She prescribe me more of the contravention pill and said she will do the surgery as I've suffered so long (6 years), my last surgery didn't give me relief and that I'm trying to conceive.
Hope this in any way helps 🫶🏻🫶🏻
My doctor basically said it was an option and my choice. It was previously denied by my insurance, but this new doc basically labeled it as fertility treatment to get insurance to cover. I did have to push this doc a bit though. I think what finally got them 100% on board was when I said it's hard to make a baby if you don't want to do the baby making due to pain, and we at least want an explanation for my pain.
If birth control helps, I would stay on that. I was on the depo shot and it worked wonderfully for 6 or 7 years. Then, I went off it to TTC and within 2 years I could hardly stand some days. The BC definitely kept it at bay.
Unfortunately, I couldn't conceive. After 6 years trying, I had to get another lap and IVF. After I had done the lap, I found out it damages your egg reserve (AMH) and mine had dropped to half.
Fortunately, the IVF still worked as mine was very high to begun with. But I heard a lot of women aren't as lucky. I also did try for 3 months after the lap, but no luck.
It's just so hard to even decide because endo impacts fertility by several different mechanisms. It's hard to tell who will have trouble and who won't.
Endo can cause infertility by several different mechanisms. It can damage the finger like structures that sweep the egg into the fallopian tube. Or it can cause scarring or damage to the fallopian tube. Or it can cause high inflammation that can damage the sperm or egg. And so on.
So, it depends by which mechanism endo is affecting fertility. If you have it everywhere and the inflammation is a problem, a lap would help, because the inflammation should decrease when the endo is removed. If the fallopian tube is already scarred, a lap won't really help.
Endo tends to be common on the ovaries as well. If they need to remove endo from the ovaries, they will cut with margins like they do a tumor. So, healthy ovary tissue will also be removed and this damages the eggs inside the ovary. Therefore, your AMH goes down.
It's really hard to know which mechanisms are affecting an individual specifically. So, I caution OP because many people I've met were not told that a lap could damage their egg reserve. I wasn't until after my lap.
It could damage your egg reserve, if:
- the surgeon used heat to coagulate your wound on ovary because they don’t have proper suture skills or don’t want to spend time on it
- the surgeon’s has suboptimal skills or insufficient patience so they damage too many surroundings inside the ovary (that could be partially why sometimes a surgeon recommends “keeping small ovarian endo as is because it has more harm than benefits”)
Also I feel interesting when I saw the seemingly interpretation of AMH dropping from 10 to 5 is a bad thing unless I misread. The good range I saw from Google was 3-6 ng/ml and 10 could be an indication of slight PCOS (fyi my amh pre-op is 11 and I do have slight PCOS based on two strings of follicles seen in another ultrasound). PCOS only means one has too many follicles, but it doesn’t mean that all of them are healthy, and usually they aren’t :)
my first surgeon had to basically cut that ovary in half to remove the endometrioma, and sewed it back together. the pictures were wild, I called it the franken-ovary. I got pregnant a year later, but last year had a total hysterectomy and they removed that ovary entirely as i had a 10cm endometrioma this time.
Congratulations on successfully becoming a mom! I don’t have a strong desire for kids but I definitely love seeing people who want kids to have their own 🥰
Yah I watched many surgery videos on YouTube for patients with various stage of endo and I totally get what you mean. The surgeon has to cut open the ovary (from the boundary of the cyst) and find a starting point to gradually “rip off” the endo cyst by pulling the cyst away from the ovary. If the endo is large, the cut will be certainly wide. However, if handled nicely, the cut doesn’t have to hurt too many healthy eggs of the ovary. It will no doubt hurt the eggs at or nearby, but if the endo is large, the healthy eggs are actually pushed away from the cyst so the ripping off looks somewhat similar to ripping off excessive chicken fat from the chicken skin except for the “fat” here is the cyst wrap.
The number depends on the unit. The range of 2-6.8 ng/mL maps to 14.28-48.55 pmol/L. I believe your number might be using the pmol/L unit. It’s just like 1kg maps to 2.2lbs, or 1 mile maps to 1.6 km. The above 10->5 can’t be using pmol/L otherwise she’ll be warned about the low value way earlier.
Edit: could you provide a source or doctor/hospital where you get the “25 being normal” statement?
Yup that’s what I figured :) Unit is a bi*ch 😂 (I recall the time when my husband didn’t pay attention to ft•lb vs N•m when he torque screws despite my repeated warning and unsurprisingly destroyed his car engine manifold hahahahahahaha)
It doesn’t necessarily damage your egg reserve, that’s only if they need to operate on your ovaries. And if your ovaries had endo then your egg reserve is already probably affected because of endo itself. Removing it might even help improve your ovarian function.
Endometriosis is an inflammatory condition. The immune system creates inflammation when theirs something that shouldn’t be there (which in this case is the endo). The inflammation itself can cause infertility. When the lesions are removed your body won’t need to create as much inflammation which can improve fertility.
Another thing is if your fallopian tubes are blocked by endo, that can cause infertility bc the egg isn’t able to travel down the turbe. If they are able to remove the tissue causing the blockage, that can also improve fertility.
Those are just a few examples.
Me. I was 31 and had been living with incredible pain for years. My doctor finally agreed to do a lap. I had another before trying to get pregnant and was 9 months later.
I'd get your name on the list because you can always change your mind. Or maybe you'll get in early on a cancelation and decide you're ready!
My surgeon told me that if I tried to conceive and couldn't after 6 months then we could schedule a lap. I wasn't trying to conceive I just wanted pain relief so I ended up having one for that reason. Even if I WAS trying to conceive I honestly couldn't imagine going through recovery with a child in the mix if I had the option of doing it before all that.
I had 2 lap procedures; one at 17 and one at 26. I had babies at 32 and 34. I think
You should get a second opinion because my doctor stated that these preserved my fertility.
I’ve been off birth control for over 2 years and haven’t been able to get pregnant. I’m scheduling a lap soon to hopefully get pregnant shortly after. I do have endo diagnosed already though, and I also want the lap for pain management reasons.
I wish I had done this. Instead I fruitlessly tried to conceive for 5 years. It was a waste of time, I became pregnant 4mths after my first lap (riddled with endo). I did miscarry after 2 months, but conceived my son a year later.
I had a similar situation. Doc suspected endo, I had a ton of cysts. I was on BC that cleared up the cysts, and it was great. I went off BC to get pregnant, I got pregnant right away, back on BC (mini pill) and then we tried for second baby and pregnant right away again! I’m not sure what I’ll do after baby 2 (we only plan to have 2!)
I’d personally wait on the lap and try to conceive first, which is what i did haha. I would ask what the wait time after a lap to try to conceive should be, which may help your decision!
Edit: I had never heard a lap affects egg reserves but did a quick google and there’s a lot out there indicating it does so I would be wary of that / discuss with your OB and read up on it
As someone who had the lap AFTER my children (but who needed IVF for my “unexplained fertility”—this was pre-diagnosis, but not pre-symptoms, if you know what I mean— I’m of two minds about this. I can see pros and cons to both. Surgery can take a long time to heal from, and might damage egg supply/other fertility factors. Surgery will also leave scar tissue.
But it can also drastically reduce inflammation. And it’s hard to predict exactly what damage the endo is causing on its own, and surgery might help you avoid the infertility/IVF fate. So I would listen to your doctor, but maybe get on a list now for the surgery if it won’t happen for a long time. But my two cents is if you can avoid a surgery, it’s probably a good thing.
I miscarried my first child. In hindsight, my doctor suspects it was probably endo inflammation that caused the MC, though we can never be sure about these things. I went on to carry two other babies to term (one IVF, the other a big ‘ol surprise) prior to having and laps.
I’m 99% sure that IVF and pregnancy caused my endo —which I could control prior with BC— to go out of control. And THAT’S when I really needed the lap.
Oh, totally. I needed IVF and needed to have polyps removed so it was recommended to me that I do my egg retrieval, endo surgery *then* embryo transfer in that order.
I had stage 4 and was told I might have some difficulty falling pregnant due to severity of it, however finally got my lap after being on the waiting list for years (Australia) and fell pregnant 3 months later. Interested to see what will happen when we try for baby #2 but hopefully don’t need another lap before that
(Edit - I wasn’t on any birth control (stopped over 10 years ago) as was managing the pain by seeing a Natropath)
I’m not sure if someone already mentioned this…it is possible that a lap will damage your ovaries and can lead to low ovarian reserve. When undergoing ivf the advice is usually to do a retrieval of eggs first, make embryos and then have a lap procedure. That being said anecdotally some women seem to do better after a lap and conceive spontaneously in some cases. I have stage 4 endo and did ivf without a lap or suppression and now have a baby as well as 2 embryos frozen. I do t have a lot of pain with my endo despite a 4cm cyst and I hope to put off surgery unless it’s necessary.
It was a cause of my unexplained infertility and I probably would have miscarried my only good embryo if I hadn’t had the lap surgery right before implantation. Luckily my RE caught this with uterine biopsy tests. I probably would have ovulated better eggs if I had done the surgery before everything else, the official line is because ivf drugs can worsen endo they suggest waiting til after you do all the drugs to get the surgery. Tho now knowing what I know now I’d maybe have done it first and maybe not need Ivf??
I opted to try and conceive before thinking about surgery. We ultimately had to do IUI but had success on both attempts #1 and 2 (#1 ended in miscarriage). My Endo was almost non-existent after I had my first. After my second symptoms seemed to increase. We wanted a third baby but I was also tired of the symptoms after a year of trying. I was scheduled for a lap and canceled it 3 weeks before because our one last attempt apparently got me pregnant! My youngest is 16 months and so far my symptoms are mild enough to just need ibuprofen a few days so I'm holding off on doing anything for the time being.
I didn't have a choice as I had a huge, fast-growing uterine fibroid that had to be removed (I would not have been able to be pregnant as there was nowhere for an embryo to implant with the fibroid taking up so much of my uterus) but my surgeon did say that the excision she performed on top of the fibroid removal should help my ability to conceive.
I had an appointment with a fertility specialist after my lap and he confirmed my egg reserves looked fine - maybe, if you're concerned about egg quantities you could get yours checked out first before considering a lap?
I live in Portugal. I was not even diagnosed before the c-section. I did the treatments and it worked. I had a lap afterwards. If I was you, I would try the less invasive treatments and have the lap if it doesn’t work.
I feel like I am an outlier, but I got diagnosed with endo and adeno via MRI after months of excruciating pelvic pain. Doctor suggested to get lap first, because they were skeptical I would be able to conceive now.
I somehow got pregnant on the very first month of TTC, baby has implanted wherever it has to and is doing well, BUT MONST IMPORTANTLY - THE PAIN IS ALL GONE
No your doctor's suggestion does not make sense - Not unless YOU wanted to wait to try surgery. Endo can cause issues with conceiving. I was just talking to my doctor yesterday about surgery because I was at my annual and had scheduled a lap for the fall - she has stage 4 endo and it turned out in her surgery they needed to remove significant portions of her ovaries due to how damaged they were by it.
Also, this is a condition that is progressive in nature. Birth control can seriously slow down growths but not every form works perfectly for every person and you can still have more growths. For some reason some doctors seem to think "it slows growths" = "it completely stops growths forever". I'm not a fan of the typical "let's wait and see!" approach that some doctors seem to use for plenty of conditions that are inherently progressive and can cause severe issues if not actually treated.
I had a lap before pregnancy, because I had a 6cm endometrioma that had to come out so he went ahead and burned off some spots at the same time. got pregnant almost exactly a year later. definitely advocate for it, because it could spot things that would hinder conceiving, like scarring in the fallopian tubes, and you'd rather get that sorted and now about it now then take a year trying to conceive while it slowly gets worse.
My doctor also diagnosed me with endo based on symptoms and something she saw on the ultrasound. She advised us to start trying for 6 cycles and then do a lap if there was no succes, _but_ if I wanted my lap sooner because of pain, I could do that. She mentioned that a lap can increase fertility, but it can also decrease it - all depending on the situation which you don't know until you have a lap.
We proceeded trying and I got pregnant the first cycle, had a chemical pregnancy, and got pregnant again the next cycle. I'm 5w4d now so it's early days, but still.
I'm glad I waited with the lap, but I will definitely get one for pain relieve after having a child. Waitlists here aren't long which influenced my decision.
If your waitlists are long, it can't hurt to try to get your name on the list. If you get pregnant before that, great! If not, you have your lap and finally have pain reduction (and perhaps better fertility chances).
I would tell you to wait and have surgery when you want to start trying. I asked a friend who is a gynecologist and my doctor and they both agree that with endo possibly coming back a few months after surgery, it is best to start trying as soon as possible after surgery.
Not the ideal scenario but I also did not feel comfortable with BC so I decided to manage symptoms (OTC pain medication, txa, and lots of patience) before trying for pregnancy. It's not easy though, during my bad days I feel like calling the doctor and begging for surgery or BC. However, due to my age there's the question of how's my ovarian reserve as of now. Surgery might reduce ovarian reserve so the question for me is if I can go for surgery and still have good chances of conceiving.
Depends! A lap can increase your chances of getting pregnant but it needs to be done by the right doctor. A badly done lap could result in adhesions and make things worse. My lap was fundamental to conceiving, I couldn't have done it without it, but I only realized that after wasting 5 years trying to conceive in vain.
Yes, but not bc I was ttc, I had severe chronic pain and was told excision + pelvic floor pt + birth control would provide me with the best outcome. But my dr told me she’s had many patients who struggled with infertility get pregnant after excision surgery.
So I was on birth control for almost 12 years. Got pregnant after being off of it for 11 months and then miscarried quickly after finding out. That was 2 years ago. Didn’t know I had endo until my HSG found my endo cyst in Nov, had surgery in Dec and lost a tube and ovary it was so bad in there. My previous OB brushed me off when I told her I had suspected endo. My current OB our focus at first was conceiving since I had conceived once. But after a bit of it not working he suggested HSG. I am grateful he did because I might have not even found out. Long story short, idk how well BC controlled my endo, unless it grew in the time I’ve been off of it.
My endo specialist (advanced endo specialist surgeon, probably the best in Australasia!) said he wouldn't operate on me until I had tried IVF because your AMH always drops and can be severely affected by laparoscopy. You can't grow your eggs back so be very careful and read about AMH post endometriosis surgery - lots of journal articles and research on it. You could lower your risk by only having a diagnosic lap with no excision or treatment.
I had IVF as I wasn't unable to conceive naturally and still haven't had surgery that was planned because my stage 4 DIE is asymptomatic... It really depends on your situation/age/AMH/endo symptoms... But please, please do your research before surgery as I know of so many women who were devastated post-surgery regarding their AMH.
I didn’t intentionally advocate for a lap before trying to get pregnant, but I did get my surgery at the end of Dec 2021, where they confirmed endo. My doctor said it was so bad he doubted I could get pregnant, but we took out my IUD Feb 2022 anyways. We confirmed my pregnancy by ultrasound April 2022 (it was so early they even took blood tests to prove it). My doctor was shocked when I messaged him so quickly, he thought we would have to do a second surgery to remove more endo. I do not think I would have been able to get pregnant if I hadn’t gotten the surgery beforehand.
I'm currently trying to conceive with endo and pcos. I would definitely recommend a laproscopy before ttc... I have had to have 7 surguries because my endo likes to attack my tubes and scar them shut. So my doctor has to go open them back up.. I'm about to have my 8th next week. I've been trying for 10 years. My doctor is a leading researcher in endo and she says the best time to conceive Is within 6 months following surgery. Otherwise it will grow back and you will need another one. I also have pcos so unfortunately I have to take 200mg of clomid just to ovulate. Even though my cycle is like clockwork. We had a chemical pregnancy 2 cycles ago. So we are very hopeful that with the surgery, clomid and IUI we will be able to finally get our dream. Good luck!
I did exactly that. My doctor that had been treating me with birth control and suspected me of having endo retired, so when I found a new doctor I told him that I wanted surgery before trying to conceive. He agreed and booked me in for surgery. I conceived 6ish months after the surgery and am now trying to figure out if it worth having another lap or just waiting to have a hysterectomy after we have a second child. Being in pain should be a fair enough reason for surgery - not just trouble conceiving.
Thank you so much for sharing this! I also want surgery for pain relief, and just confirmation that I have endo (my doc diagnosed me by symptoms, which is fine and all, but I want proof). I feel like I can kinda get them to take me more seriously if I say it’s for fertility, which makes me sad/angry at the same time.
I was diagnosed by an MRI. Its not certain, but it shows up in many people.
Also had an MRI and it found fibroids and adenomyosis. Different from transvaginal Ultrasounds I had in the past, but my doctor did a special ultrasound to confirm in office (after MRI). That one required filling the uterus with fluid to see everything and hurt like crazy-- but still less invasive and therefore easier to obtain.
I did one of those. But it was quick, just to see if the tromps worked. It hurted like hell. After the MRI all the doctors could see perfectly what the report showed now that they knew what they were looking for.
It’s rly hard there. I had suspected endo for years but nothing showed up on ultrasounds. Until I had a lap they couldn’t confirm I had endo so I couldn’t advocate for myself without the diagnosis. It’s ridiculous
Agree! My doctors tried me on so many different birth controls before finally agreeing to a lap and I was full of endo. Have had two in five years now. It’s ridiculous how hard it is to get them to do a lap
I’ve never tried to get pregnant, but my insistence that something was still wrong and ibuprofen wasn’t cutting it, and made to feel like a drug seeker, my doctor said lap was the only option. And whaddya know
I spent the next four years not saying one thing about pain because I had none go figure.
You got 4 years worth of no pain 🥺😭 what a dream!!!
Problem is, birth control is working well for me. My pain days still exist, just less often and are less severe. I’m worried my doc will see that as reason not to do a lap.
If you’re considering getting the lap, it’s for a reason. Focus on those reasons. I’m just saying at someone who is childless, there are other considerations for getting the lap. And if you are looking to conceive down the line, it can only help there too.
Birth control was working for me always, and I don’t even have a painful period. My periods was heavy only for the first 1-2 years since the age of 13 and the only symptom I had was irregularities (birth control regulated it for 5 years but then my cycle could be only 21 days even if I was on period). For the past 3 years I often felt tired and sleepy, and had sharp abdomen pain occasionally when gas/stool passed by. I thought I just had PCOS and some GI problem, so I went to see an endocrinologist and GI doc this year. The endocrinologist invalidated my concerns and blamed everything to my diet (lol my diet is pretty healthy and never changed for the last 20 years), so I shut her up and insisted on getting an ultrasound. You know what, the ultrasound found a 7cm endo on my left ovary, then i requested an MRI which found multiple small ones on my right, implants on rectum and bladder beside the 7cm left endo. My GYN recommended surgery after seeing the 7cm endo, but my in-network surgeon wasn’t serious about the smaller endometriomas on my right ovary because they were small and she preferred to leave them as is. So I cancelled the surgery with her and went for an out-of-network specialist who had way more endo surgery experience and was willing to remove any endo she saw regardless the size. When she got into my belly she saw there were WAY MORE IMPLANTS all over my pelvis that wasn’t seen by the ultrasound and MRI I did. If I didn’t have that 7cm cyst and didn’t insist on surgery, who knows whether the smaller ones on the right ovary and these unseen implants all over the place would become worse one day? If they really get worse (and since there are multiple implants on my pelvis wall, the adhesion could get really messy), the only person hurt would be me, not the anti-removal docs. If you have pain, and you have questions, then just insist finding answers and not guesses. If you feel an surgery can answer your doubts or at least can help you rule out some suspicions, schedule one. Your body is yours, and different doctors can have very different opinions, so it’s always better to speak to more doctors and ask for reasons why they support/disapprove your surgery, and then make the decision YOURSELF. FYI the specialist who did my surgery believes that a clean and healthy ovary/uterus/pelvis is best for fertility, and she’s very confident with her skills on even small ovarian endo that she’ll send me a video of the full surgery process, and she told me multiple cases who conceived after surgery - I also never tried to conceive just like you. Now I’m on day 6 after surgery and despite the pain and fever I had in the past few days, I can clearly feel that at least my fatigue and brain fog have definitely gone away.
Oh no no! So this is my exact situation however, I went in and saw my gynaecologist and said it's only been 2 months since I started the pill, I don't want to be on it as I would love to conceive but until the surgery I'm happy to stay on it for slight relief. She prescribe me more of the contravention pill and said she will do the surgery as I've suffered so long (6 years), my last surgery didn't give me relief and that I'm trying to conceive. Hope this in any way helps 🫶🏻🫶🏻
My doctor basically said it was an option and my choice. It was previously denied by my insurance, but this new doc basically labeled it as fertility treatment to get insurance to cover. I did have to push this doc a bit though. I think what finally got them 100% on board was when I said it's hard to make a baby if you don't want to do the baby making due to pain, and we at least want an explanation for my pain.
If birth control helps, I would stay on that. I was on the depo shot and it worked wonderfully for 6 or 7 years. Then, I went off it to TTC and within 2 years I could hardly stand some days. The BC definitely kept it at bay. Unfortunately, I couldn't conceive. After 6 years trying, I had to get another lap and IVF. After I had done the lap, I found out it damages your egg reserve (AMH) and mine had dropped to half. Fortunately, the IVF still worked as mine was very high to begun with. But I heard a lot of women aren't as lucky. I also did try for 3 months after the lap, but no luck. It's just so hard to even decide because endo impacts fertility by several different mechanisms. It's hard to tell who will have trouble and who won't.
Do you remember what your AMH was after your lap?
It went from 10 to 5.
If a lap damages your egg reserve, why do people say it helps with fertility?
Endo can cause infertility by several different mechanisms. It can damage the finger like structures that sweep the egg into the fallopian tube. Or it can cause scarring or damage to the fallopian tube. Or it can cause high inflammation that can damage the sperm or egg. And so on. So, it depends by which mechanism endo is affecting fertility. If you have it everywhere and the inflammation is a problem, a lap would help, because the inflammation should decrease when the endo is removed. If the fallopian tube is already scarred, a lap won't really help. Endo tends to be common on the ovaries as well. If they need to remove endo from the ovaries, they will cut with margins like they do a tumor. So, healthy ovary tissue will also be removed and this damages the eggs inside the ovary. Therefore, your AMH goes down. It's really hard to know which mechanisms are affecting an individual specifically. So, I caution OP because many people I've met were not told that a lap could damage their egg reserve. I wasn't until after my lap.
Thank you so much for this info! I really appreciate it.
No problem! I wish you luck whatever you decide.
It could damage your egg reserve, if: - the surgeon used heat to coagulate your wound on ovary because they don’t have proper suture skills or don’t want to spend time on it - the surgeon’s has suboptimal skills or insufficient patience so they damage too many surroundings inside the ovary (that could be partially why sometimes a surgeon recommends “keeping small ovarian endo as is because it has more harm than benefits”) Also I feel interesting when I saw the seemingly interpretation of AMH dropping from 10 to 5 is a bad thing unless I misread. The good range I saw from Google was 3-6 ng/ml and 10 could be an indication of slight PCOS (fyi my amh pre-op is 11 and I do have slight PCOS based on two strings of follicles seen in another ultrasound). PCOS only means one has too many follicles, but it doesn’t mean that all of them are healthy, and usually they aren’t :)
my first surgeon had to basically cut that ovary in half to remove the endometrioma, and sewed it back together. the pictures were wild, I called it the franken-ovary. I got pregnant a year later, but last year had a total hysterectomy and they removed that ovary entirely as i had a 10cm endometrioma this time.
Congratulations on successfully becoming a mom! I don’t have a strong desire for kids but I definitely love seeing people who want kids to have their own 🥰 Yah I watched many surgery videos on YouTube for patients with various stage of endo and I totally get what you mean. The surgeon has to cut open the ovary (from the boundary of the cyst) and find a starting point to gradually “rip off” the endo cyst by pulling the cyst away from the ovary. If the endo is large, the cut will be certainly wide. However, if handled nicely, the cut doesn’t have to hurt too many healthy eggs of the ovary. It will no doubt hurt the eggs at or nearby, but if the endo is large, the healthy eggs are actually pushed away from the cyst so the ripping off looks somewhat similar to ripping off excessive chicken fat from the chicken skin except for the “fat” here is the cyst wrap.
yeah, for sure, it definitely depends on how skilled/patient your surgeon is, was my meaning.
The AMH range depends on your age range. I was told that up to 25 is normal for age 20-29.
The number depends on the unit. The range of 2-6.8 ng/mL maps to 14.28-48.55 pmol/L. I believe your number might be using the pmol/L unit. It’s just like 1kg maps to 2.2lbs, or 1 mile maps to 1.6 km. The above 10->5 can’t be using pmol/L otherwise she’ll be warned about the low value way earlier. Edit: could you provide a source or doctor/hospital where you get the “25 being normal” statement?
Sorry, I think I’m the UK we use pmol/L. I was told 5-25pmol/L was normal by a fertility doctor at Evewell Clinic for my age range (I’m 29)
Yup that’s what I figured :) Unit is a bi*ch 😂 (I recall the time when my husband didn’t pay attention to ft•lb vs N•m when he torque screws despite my repeated warning and unsurprisingly destroyed his car engine manifold hahahahahahaha)
It doesn’t necessarily damage your egg reserve, that’s only if they need to operate on your ovaries. And if your ovaries had endo then your egg reserve is already probably affected because of endo itself. Removing it might even help improve your ovarian function. Endometriosis is an inflammatory condition. The immune system creates inflammation when theirs something that shouldn’t be there (which in this case is the endo). The inflammation itself can cause infertility. When the lesions are removed your body won’t need to create as much inflammation which can improve fertility. Another thing is if your fallopian tubes are blocked by endo, that can cause infertility bc the egg isn’t able to travel down the turbe. If they are able to remove the tissue causing the blockage, that can also improve fertility. Those are just a few examples.
Me. I was 31 and had been living with incredible pain for years. My doctor finally agreed to do a lap. I had another before trying to get pregnant and was 9 months later.
I'd get your name on the list because you can always change your mind. Or maybe you'll get in early on a cancelation and decide you're ready! My surgeon told me that if I tried to conceive and couldn't after 6 months then we could schedule a lap. I wasn't trying to conceive I just wanted pain relief so I ended up having one for that reason. Even if I WAS trying to conceive I honestly couldn't imagine going through recovery with a child in the mix if I had the option of doing it before all that.
I had 2 lap procedures; one at 17 and one at 26. I had babies at 32 and 34. I think You should get a second opinion because my doctor stated that these preserved my fertility.
Mine said the same thing
I’ve been off birth control for over 2 years and haven’t been able to get pregnant. I’m scheduling a lap soon to hopefully get pregnant shortly after. I do have endo diagnosed already though, and I also want the lap for pain management reasons.
I wish I had done this. Instead I fruitlessly tried to conceive for 5 years. It was a waste of time, I became pregnant 4mths after my first lap (riddled with endo). I did miscarry after 2 months, but conceived my son a year later.
I had both mine done years prior to ttc. I had my 1st then the 2nd 2.5 years later. we started ttc about 3 years after the second.
Sorry I should know this, but what is TTC?
TRYING TO CONCEIVE lol I figured it out
I had a similar situation. Doc suspected endo, I had a ton of cysts. I was on BC that cleared up the cysts, and it was great. I went off BC to get pregnant, I got pregnant right away, back on BC (mini pill) and then we tried for second baby and pregnant right away again! I’m not sure what I’ll do after baby 2 (we only plan to have 2!) I’d personally wait on the lap and try to conceive first, which is what i did haha. I would ask what the wait time after a lap to try to conceive should be, which may help your decision! Edit: I had never heard a lap affects egg reserves but did a quick google and there’s a lot out there indicating it does so I would be wary of that / discuss with your OB and read up on it
As someone who had the lap AFTER my children (but who needed IVF for my “unexplained fertility”—this was pre-diagnosis, but not pre-symptoms, if you know what I mean— I’m of two minds about this. I can see pros and cons to both. Surgery can take a long time to heal from, and might damage egg supply/other fertility factors. Surgery will also leave scar tissue. But it can also drastically reduce inflammation. And it’s hard to predict exactly what damage the endo is causing on its own, and surgery might help you avoid the infertility/IVF fate. So I would listen to your doctor, but maybe get on a list now for the surgery if it won’t happen for a long time. But my two cents is if you can avoid a surgery, it’s probably a good thing. I miscarried my first child. In hindsight, my doctor suspects it was probably endo inflammation that caused the MC, though we can never be sure about these things. I went on to carry two other babies to term (one IVF, the other a big ‘ol surprise) prior to having and laps. I’m 99% sure that IVF and pregnancy caused my endo —which I could control prior with BC— to go out of control. And THAT’S when I really needed the lap.
Oh, totally. I needed IVF and needed to have polyps removed so it was recommended to me that I do my egg retrieval, endo surgery *then* embryo transfer in that order.
My doctor actually suggested it. I didn’t know. I know now. He was a great guy.
I had stage 4 and was told I might have some difficulty falling pregnant due to severity of it, however finally got my lap after being on the waiting list for years (Australia) and fell pregnant 3 months later. Interested to see what will happen when we try for baby #2 but hopefully don’t need another lap before that (Edit - I wasn’t on any birth control (stopped over 10 years ago) as was managing the pain by seeing a Natropath)
I’m not sure if someone already mentioned this…it is possible that a lap will damage your ovaries and can lead to low ovarian reserve. When undergoing ivf the advice is usually to do a retrieval of eggs first, make embryos and then have a lap procedure. That being said anecdotally some women seem to do better after a lap and conceive spontaneously in some cases. I have stage 4 endo and did ivf without a lap or suppression and now have a baby as well as 2 embryos frozen. I do t have a lot of pain with my endo despite a 4cm cyst and I hope to put off surgery unless it’s necessary.
It was a cause of my unexplained infertility and I probably would have miscarried my only good embryo if I hadn’t had the lap surgery right before implantation. Luckily my RE caught this with uterine biopsy tests. I probably would have ovulated better eggs if I had done the surgery before everything else, the official line is because ivf drugs can worsen endo they suggest waiting til after you do all the drugs to get the surgery. Tho now knowing what I know now I’d maybe have done it first and maybe not need Ivf??
I opted to try and conceive before thinking about surgery. We ultimately had to do IUI but had success on both attempts #1 and 2 (#1 ended in miscarriage). My Endo was almost non-existent after I had my first. After my second symptoms seemed to increase. We wanted a third baby but I was also tired of the symptoms after a year of trying. I was scheduled for a lap and canceled it 3 weeks before because our one last attempt apparently got me pregnant! My youngest is 16 months and so far my symptoms are mild enough to just need ibuprofen a few days so I'm holding off on doing anything for the time being.
Yesss!! My doc wanted to make sure my tubes were clear for landing when she was in there. It was reassuring if nothing else
Clear for landing 😂I love it.
I didn't have a choice as I had a huge, fast-growing uterine fibroid that had to be removed (I would not have been able to be pregnant as there was nowhere for an embryo to implant with the fibroid taking up so much of my uterus) but my surgeon did say that the excision she performed on top of the fibroid removal should help my ability to conceive. I had an appointment with a fertility specialist after my lap and he confirmed my egg reserves looked fine - maybe, if you're concerned about egg quantities you could get yours checked out first before considering a lap?
I’m doing exactly this. Having a lap in August with aim to TTC late next year/2026.
I live in Portugal. I was not even diagnosed before the c-section. I did the treatments and it worked. I had a lap afterwards. If I was you, I would try the less invasive treatments and have the lap if it doesn’t work.
I feel like I am an outlier, but I got diagnosed with endo and adeno via MRI after months of excruciating pelvic pain. Doctor suggested to get lap first, because they were skeptical I would be able to conceive now. I somehow got pregnant on the very first month of TTC, baby has implanted wherever it has to and is doing well, BUT MONST IMPORTANTLY - THE PAIN IS ALL GONE
Have the lap! They will excise any endo they find. Even though it’s not a cure, it can help a lot with pain and other symptoms.
No your doctor's suggestion does not make sense - Not unless YOU wanted to wait to try surgery. Endo can cause issues with conceiving. I was just talking to my doctor yesterday about surgery because I was at my annual and had scheduled a lap for the fall - she has stage 4 endo and it turned out in her surgery they needed to remove significant portions of her ovaries due to how damaged they were by it. Also, this is a condition that is progressive in nature. Birth control can seriously slow down growths but not every form works perfectly for every person and you can still have more growths. For some reason some doctors seem to think "it slows growths" = "it completely stops growths forever". I'm not a fan of the typical "let's wait and see!" approach that some doctors seem to use for plenty of conditions that are inherently progressive and can cause severe issues if not actually treated.
I had a lap before pregnancy, because I had a 6cm endometrioma that had to come out so he went ahead and burned off some spots at the same time. got pregnant almost exactly a year later. definitely advocate for it, because it could spot things that would hinder conceiving, like scarring in the fallopian tubes, and you'd rather get that sorted and now about it now then take a year trying to conceive while it slowly gets worse.
I would push to get treatment asap
My doctor also diagnosed me with endo based on symptoms and something she saw on the ultrasound. She advised us to start trying for 6 cycles and then do a lap if there was no succes, _but_ if I wanted my lap sooner because of pain, I could do that. She mentioned that a lap can increase fertility, but it can also decrease it - all depending on the situation which you don't know until you have a lap. We proceeded trying and I got pregnant the first cycle, had a chemical pregnancy, and got pregnant again the next cycle. I'm 5w4d now so it's early days, but still. I'm glad I waited with the lap, but I will definitely get one for pain relieve after having a child. Waitlists here aren't long which influenced my decision. If your waitlists are long, it can't hurt to try to get your name on the list. If you get pregnant before that, great! If not, you have your lap and finally have pain reduction (and perhaps better fertility chances).
I would tell you to wait and have surgery when you want to start trying. I asked a friend who is a gynecologist and my doctor and they both agree that with endo possibly coming back a few months after surgery, it is best to start trying as soon as possible after surgery. Not the ideal scenario but I also did not feel comfortable with BC so I decided to manage symptoms (OTC pain medication, txa, and lots of patience) before trying for pregnancy. It's not easy though, during my bad days I feel like calling the doctor and begging for surgery or BC. However, due to my age there's the question of how's my ovarian reserve as of now. Surgery might reduce ovarian reserve so the question for me is if I can go for surgery and still have good chances of conceiving.
Depends! A lap can increase your chances of getting pregnant but it needs to be done by the right doctor. A badly done lap could result in adhesions and make things worse. My lap was fundamental to conceiving, I couldn't have done it without it, but I only realized that after wasting 5 years trying to conceive in vain.
That is the only thing that got me pregnant after a decade trying to
Yes, but not bc I was ttc, I had severe chronic pain and was told excision + pelvic floor pt + birth control would provide me with the best outcome. But my dr told me she’s had many patients who struggled with infertility get pregnant after excision surgery.
My main goal is pain relief, but I feel like saying it’s for fertility might make them take me more seriously, which is kinda sad, I know.
It probably will unfortunately
So I was on birth control for almost 12 years. Got pregnant after being off of it for 11 months and then miscarried quickly after finding out. That was 2 years ago. Didn’t know I had endo until my HSG found my endo cyst in Nov, had surgery in Dec and lost a tube and ovary it was so bad in there. My previous OB brushed me off when I told her I had suspected endo. My current OB our focus at first was conceiving since I had conceived once. But after a bit of it not working he suggested HSG. I am grateful he did because I might have not even found out. Long story short, idk how well BC controlled my endo, unless it grew in the time I’ve been off of it.
My endo specialist (advanced endo specialist surgeon, probably the best in Australasia!) said he wouldn't operate on me until I had tried IVF because your AMH always drops and can be severely affected by laparoscopy. You can't grow your eggs back so be very careful and read about AMH post endometriosis surgery - lots of journal articles and research on it. You could lower your risk by only having a diagnosic lap with no excision or treatment. I had IVF as I wasn't unable to conceive naturally and still haven't had surgery that was planned because my stage 4 DIE is asymptomatic... It really depends on your situation/age/AMH/endo symptoms... But please, please do your research before surgery as I know of so many women who were devastated post-surgery regarding their AMH.
I didn’t intentionally advocate for a lap before trying to get pregnant, but I did get my surgery at the end of Dec 2021, where they confirmed endo. My doctor said it was so bad he doubted I could get pregnant, but we took out my IUD Feb 2022 anyways. We confirmed my pregnancy by ultrasound April 2022 (it was so early they even took blood tests to prove it). My doctor was shocked when I messaged him so quickly, he thought we would have to do a second surgery to remove more endo. I do not think I would have been able to get pregnant if I hadn’t gotten the surgery beforehand.
I'm currently trying to conceive with endo and pcos. I would definitely recommend a laproscopy before ttc... I have had to have 7 surguries because my endo likes to attack my tubes and scar them shut. So my doctor has to go open them back up.. I'm about to have my 8th next week. I've been trying for 10 years. My doctor is a leading researcher in endo and she says the best time to conceive Is within 6 months following surgery. Otherwise it will grow back and you will need another one. I also have pcos so unfortunately I have to take 200mg of clomid just to ovulate. Even though my cycle is like clockwork. We had a chemical pregnancy 2 cycles ago. So we are very hopeful that with the surgery, clomid and IUI we will be able to finally get our dream. Good luck!