Am I making the right decision?

[ababy4us]

Hi ladies, I need some advice/perspective. I am scheduled to have a Laparoscopy procedure to investigate and remove endometriomas on my ovaries next Monday (2 days before Christmas...ugh!). This is a pretty standard procedure but it my case its a bit different because I have DOR. My RE suggested we try IVF before we did surgery since this procedure could potentially destroy any little fertility I have left. We took his advice and it failed miserably. We had poor response, which is to be expected for someone with DOR but I had IUIs with minimal meds and had great responses so it wasn't what anyone had expected. As my signature says the IVF failed and we only had one little embryo of poor quality
My RE says this is the logical next step and this is what I wanted but as the time gets closer I'm having doubts. My biggest fear is I will wake up with nothing left. Please share experiences, friendly advice, anything. Thank you for reading if you made it this far into my post

 

[ababy4us]

Anyone?

 

[ababy4us]

Thank you. If only we has a crystal ball, right?

 

[Milty]

I hope your lap went well ...sorry I was to late to post.

I saw that you said you had DOR and endo and wanted to mention to you immunity testing. DOR and endo are both associated with over active immunity. A lot of docs over look this testing but it can be a huge difference for you.

If I were you the first thing if have done after your lap is a full immunity work up done including NK testing.

 

[pennymarie]

I really hope you are well ababy4us!!

 

[Christi85]

I know this is an older post, but, ababy4us, did you end up having a laparoscopy?
If so, did it affect your fertility and ovarian reserve as you were fearing?
I'm in a very similar boat: I have a lap scheduled for 5/22 with an AMH of 0.96 and AFC of 10 follicles (no medications). The lap is primarily to remove an ovarian cyst and also to check for endometriosis before I proceed to treatment (IUI or IVF). I am also scared because of my low AMH that the cyst removal may cause it to drop further. However my cyst is either an endometrioma or a dermoid - doctor wasn't sure from the ultrasound. She says if it's endo, she can aspirate it, though it's best removed, as it could grow back with aspiration. If it's a dermoid, it needs to be removed no matter what, as it could cause infection with IVF needles. On the one hand, I'm so scared I'll wake up with nothing left like you said, on the other hand I recognize ovarian cysts need to be removed (especially if it ends up being a dermoid, as there's a low chance it could develop to something malignant over time), so I'm prioritizing my general health over my fertility. But I'd love to know about your experience and the outcomes of your lap.

 

[ababy4us]

Hi Christi!

My AMH and AFC is so similar to yours. My lap went well and I have no endo anywhere except my left ovary. We left everything in place and didnt remove or aspirate because with IVF we can work around it. All in all I am glad I did the Lap so we know for sure but I have mixed feeling in whether or not I should have just had the endometrioma removed since it could be the cause of my DOR. If, heaven forbid this ICSI doesn't work I will push to have it removed because I will feel I've tried everything. I hope this helps and I wish you the best!!

 

[Christi85]

Hi Christi!

My AMH and AFC is so similar to yours. My lap went well and I have no endo anywhere except my left ovary. We left everything in place and didnt remove or aspirate because with IVF we can work around it. All in all I am glad I did the Lap so we know for sure but I have mixed feeling in whether or not I should have just had the endometrioma removed since it could be the cause of my DOR. If, heaven forbid this ICSI doesn't work I will push to have it removed because I will feel I've tried everything. I hope this helps and I wish you the best!!

Thank you for your response. Huh, I knew that ovarian endometriomas can cause quality issues with eggs, but had no idea they can actually cause DOR too (actually impacting the quantity of eggs) . It kinda makes sense though, as I only had 3 follicles in the ovary where the cyst is. The other one had much more of a normal count (7 visible follicles and possibly a couple more, as part of the ovary was hiding behind the uterus and was not visible on ultrasound). I know, it's kinda being between a rock and a hard place, isn't it? You either remove the cyst and risk damaging remaining tissue, or you leave it in and risk well...damaging remaining tissue
My doctor had told me she wouldn't care too much if I had a confirmed history of endometriomas, but we don't know. I've had cysts before which would go away with BCP, but I've stopped taking these in 3 years now, long before we started TTC. She's concerned it may be a dermoid though as it looks a little non-uniform in ultrasound, and if that's the case, she wants it out, as it could cause infections when doing fertility treatment, especially if I did IVF and had to do egg retrieval, interfering with the needle and all. I feel she's right. Since yours turned out to be an endometrioma, I can see why your doctor took the approach they took. I did ask my doctor about tissue loss, and she confirmed this can happen in some cases She did say, however, that they are extremely careful when removing to cause the least possible damage, especially in women of reproductive age. I just have to trust her to do a fine job and at least I'm hopeful it won't do much damage, as the cyst isn't that big (just about 3.5cm).
I wish you all the best as well!!

 

[ababy4us]

Its like im looking into the infertility mirror. haha

Same with me my left ovary (endo ovary) had 3 AFC and right 7-9 AFC. Still low but if the left was the same as the right it would be within normal range. I do belive you should trust your doctor, sounds like you are in very good hands Please keep me posted, I'm anxious to hear how it goes for another endo/DOR gal.

 

[Christi85]

Its like im looking into the infertility mirror. haha

Same with me my left ovary (endo ovary) had 3 AFC and right 7-9 AFC. Still low but if the left was the same as the right it would be within normal range. I do belive you should trust your doctor, sounds like you are in very good hands Please keep me posted, I'm anxious to hear how it goes for another endo/DOR gal.

Thank you, will do.
I know, my doctor said she'd wanted to see 7-9 eggs in each ovary, so if my 'bad' ovary (incidentally, mine's the right one) had the same number, I too would have been within the normal range