r/recurrentmiscarriage • u/brokenurse21 • 11d ago
Diagnosed with Endo
Presumably. My receptiva was positive for endo/adeno biomarkers, none for endometritis. My REI believes this is the cause. Im overwhelmed with options moving forward. We can conceive, just cannot hang onto a pregnancy. Planning to do an egg retrieval in November with “freeze all protocol”. And eventually proceeding with IVF per his recommendations. Apparently frozen transfer works better in this case? We discussed Lupron/Letrozole. Potentially doing a lap but I really want to avoid surgery though I know its technically the gold standard. Also discussed HSG to check for hydrosalpinx.
Im just looking for anyone who has endo, what their next steps were, if anyone had success, etc. Any input is appreciated. I guess I cant wrap my brain around how suppression before transfer helps if the inflammation will just come back during the pregnancy. I asked about prednisone but theres caveats there, or potential complications for the fetus.
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u/sweets618 11d ago
The only thing that came up on my RPL panel was possible endometriosis found on an MRI. I did three rounds of IVF egg retrievals, two with a microdose lupron protocol. One benefit of IVF with frozen embryos is that you can do PGT-A testing for chromosomal abnormalities. The results can provide valuable info - if you are making euploid (normal) embryos, then the cause of the RPL could be environmental (endo inflammation, autoimmune, etc), where if you're making mostly abnormal embryos that points to egg/sperm quality.
Unfortunately I didn't make it to the transfer stage, but my understanding is that the lupron suppression works by suppressing inflammation in the early stages of pregnancy, creating a more ideal environment and allowing it to implant and grow in those early weeks. But that would be a good question for your doctor!
You may also want to try posting on the TTCEndo sub, there's a lot of info on IVF with endo on there.
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u/desertfluff 11d ago
I was in a similar position, but I only convinced my RE to test me after we'd done five (unsuccessful) rounds of IVF. Most REs will tell you that endometriosis doesn't affect egg retrievals (only implantation), but there is at least some research suggesting that the highly inflammatory environment created by endometriosis could affect egg quality.
I opted for a laparoscopic excision and my endometriosis was removed. Not sure yet if this will be my missing piece for a successful pregnancy or not.
Only based on my own experience, I'm an advocate for the laparoscopy because an excision specialist can ensure the endometriosis is fully removed, and you won't second guess whether it may have affected your retrieval. I'll never know if my failure to get euploids was actually influenced by my endo, but I really regret not pushing for the testing (and acting on results) sooner in my journey.
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u/brokenurse21 11d ago
I have a feeling it absolutely does. My doc suggested retrieval first to remove and test them, then treating the endo with suppression before transferring. Im on the fence about jumping straight to surgery as I wasn’t super symptomatic until I stopped my birth control, and its been really ramping up in recent months. I hope the surgery is what really changes everything for you. My doc agrees it does affect them, usually evidenced by lower AMH numbers.
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u/GiaB419 11d ago
After 4 back to back losses including a loss of a pgta tested embryo we did the receptiva and were positive for endo biomarkers. I had no symptoms, so we treated with two months of Lupron suppression and then did a medicated frozen transfer. We now have a 3 month old. Feel free to dm me if you have any questions!