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Question 8: Falling pregnant with stage IV Endometriosis

Question:

Dear Dr Edelstein,

Hubby and I have decided that I will stop using Visanne. We want to start trying to conceive again after my next cycle.

Any advice on what I can take to improve my chances? Just a bit of history. I was diagnosed with endometriosis in 1998 and the diagnosis was confirmed in 2001 via laparoscopy. Since then I have had 7 laparoscopies and my most recent operation was a laparotomy (25th June). I have stage 4 endo. With the last op the Dr did excision surgery and removed all endo as well as endo on my bowel. Hubby and I have been ttc’ing for 5 years now. Took a 6 month break while I was on Visanne. We have done 6 cycles with Clomid and Estrofem, as  well as 2 cycles IUI.

I have seen on Fairhaven that they sell Fertilaid, I have bought some this month, and hoping that it will make a difference.
Hubby’s last sperm test was last year October, when we did the IUI’s, and the dr at that stage said that everything was normal.
The Dr did however say, that he would suggest that we still rather try with help.
Was just hoping that maybe you have some advice for me please.

Answer:

I am sorry to learn about your difficult history.

I would recommend 3 months of hormonal suppression following extensive surgery, before planning assisted reproduction treatment. Depending on the patency of your fallopian tubes, your ovarian reserve & your husband’s semen analysis, you could either continue  with artificial insemination (2 more cycles) or move to in-vitro fertilisation (IVF).

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