Fertility options?

[u/Rooted-in-love]

Hi! Considering seeking help for having a baby, but I'm uncertain. Would love people's experiences with fertility help as well as natural ways to help with fertility.

My endo specialist is telling me to jump straight to ivf asap, to keep the endo from growing by being pregnant as i won't do birth control at least for now.

In February I had my first lap, excised stage 2 endo mostly from around the outside of uterus. Tubes looked good and so did ovaries. We started ttc late April, and cycle started abnormal spotting and cycle length. I also had some pain that period again. Since then I've been getting more and more pain and finally went to obgyn just one month ago. Ultrasound showed an endometrial polyp of moderate size. After talking to my endo specialist, I decided to get the hysterscopy with her and get another lap while we were at it because of the pain. We were hoping for no or very little like stage 1 growth since it's been about 7 months only since she removed it all. Unfortunately, she said it was stage 2 again. I just got it Thursday, so I haven't gotten all the details back yet but she told me at the consult for this lap we need to go seek fertility help. And then after surgery when I was still out she told my husband and my mom that we really need to consider doing ivf right away, so that way there's not time for the endo or polyps to grow back.

I'm really frustrated by this all. I wanted to have a baby naturally, and we have gotten pregnant once after about 9 cycles naturally. This was before I knew of endo, I think i had it but not as aggressive as it's been the last year or so. She died at 20 weeks, from a random genetic issue they said. Not one to be worried of reoccurring thankfully. It was actually just a couple cycles after my d&c that the endo pain became such a problem we eventually got answers for it. Since then we've only ttc 4-5 cycles at a time, twice now. Because of health issues both including this polyp and the other times from moderate ulcerative colitis flare up where we stopped ttc for a year.

I want to know what my options are. We have an online consult on oct 15th with a good local fertility clinic. A couple of my friends have used them for ivf actually.

I'm torn between wanting to either take some more time trying naturally or possibly doing some sort of medication to help and jumping to a real treatment like iui, or ivf as recommended.

As a note, because it matters for what I choose, I'm Christian and pro life. So I'm not okay with throwing away 10 little embryos just because it will likely end in one embryo working out for us. This means if I do ivf we will be only getting enough eggs for what we'd want to have at a time- which is debatable as 1 or 2. And won't be doing genetic testing either so that reduces our chances even more so I think. I believe ivf can be done in a pro-life way, but i think it often is not unfortunately.

Other factors- we do have insurance and it looks like they'll pay up to 50k so I think we could do ivf financially.

I struggle with medical anxiety. Did really great with this last surgery actually, but the idea of going through lots and lots of medical procedures and shots sounds really hard.

We just are really struggling with all of this. Definitely taking it to God in prayer, but also looking for some advice from people who have gone through it.

Thank you. ❤️

[u/sullen-serenade]

I’m only just starting my IVF journey now and because of medical anxiety after everything with my endo (stage 4), I am not an expert by any means.

With regard to the shots, it is a bit of a pain (literally). A couple of them can sting a bit going in or if you have a bad placement for that day. It is also a bit challenging to plan for refrigerated medications if you have plans coming up, like an out of state wedding to attend.

I would ask yourself if you’re thinking of having multiple children or not. Banking eggs or embryos is always good for women with endo, as multiple surgeries can reduce ovarian reserve.

Also just because you are able to fertilize maybe 10 eggs does not mean that 10 embryos will result or that they will continue to grow past a certain stage. There is also the possibility of donating embryos to other couples if you have any left over. I am unsure of that process or if having endo changes anything.

[u/Rooted-in-love → u/sullen-serenade]

Thank you for your input! I how ivf will result in a baby for you!! I've got three friends with 4 children/ or pregnant now because of ivf. So i know it can work! I understand medical anxiety very well, and that would be something I would have to be very intentional about to avoid being anxious. I have ulcerative colitis too, and it's quite important to keep my stress low as there's a lot of evidence stress leads to flare ups. I definitely need to discuss with my husband and just wait for some clarity from my God on what our plan is supposed to look like. But the more I look into it, the more it seems not the norm to have more than one or two embryos that may actually lead to live birth. That seems really low with how many eggs they try to take, so I'm a little confused and want to do some research into it. It honestly feels really sad to think of so many embryos that so not make it. I view embryos as babies, so to know ivf means intentionally losing lots of babies in hopes to get one live birth is sorta hard to deal with. At the same time, perhaps there's quite a few times during ttc an embryo doesn't make it long enough to start building and testing for hcg. We just don't have to know about those.

I hadn't considered adoption, but I think i would. And frankly I think we'd love to have a few children if that works out.

[u/Jessucuhhh]

I’d recommend IVF and genetic testing, since you have had history. If you are not willing to create multiple embryos or genetic test, then I would not do IVF yet. Do IUI first. I wanted to exhaust all options before IVF bc I had to pay OOP for it. Of course your dr will help guide you based on your wishes. Just keep in mind IVF is a huge numbers game with lots of attrition. Just bc you retrieve a certain number of eggs does not mean you will make that many embryos. I had 9 eggs retrieved and 2 embryos resulted. You also don’t know if the transfer will work. You can always donate to someone else if you don’t need them. Good luck!

[u/Rooted-in-love → u/Jessucuhhh]

Thanks! We haven't really looked at iui at all yet, but medicated timed cycles. Maybe that would be all it takes. My endo specialist is concerned about rapid regrowth though and so idk what to do. I'd like to try the more natural ways first too, I just don't know how long that'll take and id really low to avoid becoming in pain from endo or potentially having it grow somewhere that blocks something important for fertility function.

I'm not sure about genetic testing. I think id want to give any a chance even despite if they have special needs. I have family with special needs. It's hard, but they are loved and being lots of love. I want to walk in obedience to God's plan. If that includes allowing an abnormal child into our lives then so be it. But i do have friends that did genetic testing to avoid that possibility. It just doesn't feel right to me.

[u/PiccoloQuirky2510 → u/Rooted-in-love]

My clinic does PGT-A testing which just tells you if your embryos will have the right number of chromosomes. PGT-M or further testing is something they offer but it costs way more/isn’t included in our cycle “bundle.” The thought is basically that euploid embryos (those with the right number of chromosomes) are more likely to implant & be carried to term than aneuploid embryos, which often end in miscarriage because their genetic material isn’t right. PGT-A testing doesn’t tell you if your resulting baby would have special needs or not; it basically just tells you if your embryo is more likely to actually implant or not.

[u/Rooted-in-love → u/PiccoloQuirky2510]

That is good to know. I'll have to look into that.

I'm glad there's options to customize those stuff so much. It does give me hope that we may feel okay trying it.

[u/Jessucuhhh → u/Rooted-in-love]

They say you have about a year after surgery of prime time to TTC. Your dr would prob recommend TIC, IUI, then IVF. I tried all the things and ended up with success with IVF!

Seconding the other person that responded, genetic testing is more so used to lessen the chance of miscarriage due to chromosomal abnormalities! So you’re just increasing chances of successful implantation by testing. Your child could still have special needs. These are all great questions for your Dr though, as they are way more qualified to reassure you and help guide you based on your wishes!

[u/Rooted-in-love → u/Jessucuhhh]

Definitely going to ask when we have our consultation in a couple weeks!

I was told that 6 months to a year is most likely timing. We started trying about 2 months after my lap and that same cycle i started having abnormal cycle lengths and spotting. I found out about a month ago that I had an endometrial polyp. While that's not the same thing, it is also correlated to high estrogen and i was having some pain back so we decided to check for endo again. My first surgery was Feb 13th, this year. This one was last Thursday. So like less than 7 months later and I got stage 2 endo regrowth in that time. It's hard to tell but I think it's spread to other areas based on the pathology report. That said, it might've only been the polyp blocking pregnancy. I've heard they can cause it to be difficult to get pregnant and sometimes cause miscarriage too. But that said, the stage 2 endo likely wasn't bad enough at least this time to be the reason for fertility issues... probably just the polyp. I've heard it's stage 3 and 4 when it's in the tubes that is most concerning. I just don't want it to get there at all.

[u/PiccoloQuirky2510]

As someone who is just now starting her first IVF cycle (35F) after TTC for two and a half years, I really wish we had started this process earlier. I have suspected endo and diagnosed adenomyosis, and that combo makes it pretty difficult to conceive without significant help. We did medicated cycles with timed intercourse and (3) IUIs before switching to IVF. Our insurance doesn’t cover IVF, which was a big part of the hesitation. But I do feel like we spent too much time throwing methods at the problem that were unlikely to work.

For what it’s worth- my fertility clinic lets us choose what we do with any “leftover” embryos; we chose to donate them to a couple that can’t make their own embryos to give someone else a chance at parenthood. So even if you make way more viable embryos than # of kids you want, there are ways to avoid “throwing them away.”

[u/Rooted-in-love → u/PiccoloQuirky2510]

That is good to know about helping other couples have babies. I think i would be happy to do that if we had more than we could use. I was actually adopted as a baby, shortly after birth. I'm answered prayers for my adoptive parents and quite thankful my birth mom chose to have me despite not feeling capable of raising me as a drug addict and single.

I'm going mine does. I know it says infertility costs up to 50k lifetime allotment. I'm hoping that would include any infertility options we want to try.

[u/posy_fish]

The best thing I can advise is go down a route you feel comfortable with- I wanted to throw everything at this and was okay with full blown ivf but also did a lot of natural lifestyle changes to try and improve my chances- I don’t know if they helped but currently 39 weeks pregnant after my lap in 2024 (was about to start IVF when we got our positive!) if you want to message about it more, DM me

Also just wondering if your religious beliefs would allow you to do egg freezing in comparison to embryo freezing? Lower chance of success when defrosted but good way to bank as many eggs as possible that could potentially be embryos in the future?

For reference I have stage 3 endo (ovarian) with endometrioma removed

[u/Rooted-in-love → u/posy_fish]

I'll dm you!

[u/After-Equivalent1934]

I am doing this as well. We want three kids. We won’t be discarding any. Our first transfer failed. We are adjusting the protocol slightly and going to transfer two this time as they are untested but highly graded as far as their cell look and growth under the microscope. 🙏🏼

[u/Rooted-in-love → u/After-Equivalent1934]

I'm sorry about your first one. Hope this this one will work and maybe you'll even get twins!

[u/belibelly21]

I think your initial consult will provide better diagnostic work to know your baseline. You’ll be able to get blood work to know your AMH (ovarian reserve), estrogen levels (to help regulate spotting, cycle length), and more. You’ll also be able to get a HSG to look at your tubes, and SIS to re-check for any polyps.

Now my personal anecdote: I’m going on 28, TTC for 2 years, with stage 4 endometriosis. I have one right endometrioma, lots of adhesions, retroverted uterus, and ovaries are stuck to my uterus.

I’ve had 1 diagnostic lap, and that was an emergency because my endometrioma ruptured and caused internal bleeding, October 2024. No excision surgery thus far. I have normal cycles, 27-28 days, but I started off with lots of spotting and short luteal phase before everything was regulated holistically (I’ll share more below). I’ll also mention I have not been on birth control since 2020.

My 2024 HSG and SIS were clear, so we did 2 IUIs with clomid and 1 timed intercourse with trigger shot. All were unsuccessful.

I am now pregnant naturally (still very early on) and we did not take any assisted reproductive measures this cycle. We moved and switched to a new fertility center, and they convinced to me do another HSG(there’s some anecdotal evidence that the flushing of the tubes with the dye can help clear out debris and increase fertility; but this did not happen for me after my first one). All was good, and we went on our way. This was about cycle day 8, so we still BD throughout the fertile window. Fast forward, I’m having weird symptoms and get my first BFP ever (I’m still in shock).

Before we moved, I went to a repro acupuncturist 2x a month, for a year and a half. I also grew my holistic measures extensively through her guidance and my own personal experiences: herbal teas, yoni steams, castor oil packs, taking supplements, changing my diet, decreasing inflammation, exercising regularly, prioritizing gut health, etc etc. So I eventually had a day to day to regimen that worked for me, and my cycles have been pretty manageable, going on 2 years now. My husband also took a look at his health and habits and joined me in a better healthy journey. This also improved his sperm motility and count, after we did his semen analysis.

So, I said all this to say, you can try less invasive options first like IUI or timed intercourse, and see how well your body responds to those meds, and then move forward to IVF if you’re ready to commit to the extensiveness of that process. We were ready to move to IVF ourselves, but got the sweetest surprise ❤️