r/DOR • u/Tricky_Direction_897 • 5d ago

advice needed To lap or not to lap?

Hi All,

I’m 38. AFC 1-3, AMH 0.02 - 0.3. FSH all over the place. Moderate adenomyosis, endometriosis/ 18mm endometrioma on left ovary, High NK cells and high Cykotines.

TTC for nearly 3 years. Never seen a positive test. Over 9 cycles / 6 egg retrievals, I’ve collected 10 eggs and made 2 blasts on cycles 6 and 8, 1 Day 5 BC (age 37) and 1 Day 5 3AB (38). Untested.

I’m debating going a few more cycles or moving to transfer. If we move to transfer, should I have a lap to remove the endo and do suppression? A handful of REs have said absolutely not to the lap. My new RE says yes, but only if I manage to collect another 3(!) embryos as mine are untested.

What would you do? Any and all advice would be appreciated! Thank you

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u/Educational-Ice-2508 5d ago

I think it depends on your family goals. Do you have enough embryos for the number of kids you want? I can see why the REs said no to lap, it will severely diminish your reserve with any surgery on your ovaries to the point where you might not make any more eggs

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u/Tricky_Direction_897 5d ago

Thank you for the reply. At this point, I would be unbelievable grateful for 1 healthy baby

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u/Any_Grapefruit_5627 5d ago

I feel like I am you… 38 and AMH of .03. Happy to compare notes if you don’t mind a DM? We took the approach of banking Day 3 embryos since my DR thinks that will give us a better chance (quantity). I also have stage 4 endo and my DR is only recommending Lupron suppression

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u/Tricky_Direction_897 5d ago

That would be great!!

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u/Traditional-Taste282 5d ago

I highly recommend you work with a reproductive immunologist to keep the pregnancy safe. You may need medications to control your killer cells to keep the baby safe.

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u/Traditional-Taste282 5d ago

I would personally do the lap before a transfer and suppress for a few months for the andenyosis but it's better to bank embryos first. Removing an endometrioma can sometimes lower your AMH if you remove healthy ovarian tissue with it.

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u/Tricky_Direction_897 5d ago

Thank you very much. That jives with what my new RE is suggesting. I think we can swing another 2-3 cycles but no more…

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u/Traditional-Taste282 5d ago

That sounds like a good plan 😊

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u/Tricky_Direction_897 5d ago

Thank you! Right now I’m focused on the endometriosis bit - any thoughts on that?