u/Jaded-Addendum-4489

Hi all! I had an IVF consult today with a different clinic and I really liked the doctor. However, she has two approaches to suppression for endometriosis.

Your standard 2 months of suppression monthly shots with Lupron OR daily low-dose Lupron down regulation for 2-3 weeks.

I know the gold standard is the 2 months, but my doctor said she has seen success in both scenarios and that the 2 months is best for those who haven’t had surgery (I had surgery in April).

Background: 20 months TTC, 3 CPs, stage III endo excised in April 2026. My husband and I have completely normal labs (we have done extensive testing), I ovulate on my own and normal cycles.

I underwent excision surgery back in April 2026. She excised stage III endo and drained three endometriomas (drained a 2cm one on my R ovary and two 3 mm endometriomas on my L ovary). I have also been TTC for going on 19 months (have had three chemicals prior to surgery).

My right side period cramping pain is back. Even when ovulating on my L, my period pain consists of cramping/radiating pain on my right side. This is where my larger endometrioma was and where my ovary was tethered back. Unfortunately, this right sided pain is back. It includes lower right abdominal pain, which also goes down my right leg (it used to go to my knee by its now to my thigh) and right tailbone pain. Does this mean it’s back? I’m so worried and sad. We just want to be parents. I found out about my endometriosis at 5 months TTC through an ultrasound when my R endometrioma was found 😔. Anyone have any thoughts? I’m desperate on wanting to alleviate pain and get (and stay) pregnant.

Dx with stage III endo back in April during my excision surgery. She excised it all and drained three small endometriomas (2cm on R and two 3mm on L). I have also have had three chemicals. All before my surgery.

I have done extensive testing that all came back negative/normal:

AMH, AFC, FSH, estradiol, progesterone, LH, prolactin, testosterone, vitamin D, full thyroid panel, RPL testing, HSG, hysteroscopy, endometrial biopsy for chronic endometrITIS and EMMA/ALICE, semen analysis and DNA fragmentation, NK cells, TNF-a, IL-6, APS, ANA, CA-125, iron/ferritin/B12, and fasting glucose/A1C/insulin…

5 failed rounds of Letrozole, trigger shot and TI, and two failed IUIs with Gonal-F with trigger. 4/5 Letrozole cycles were before surgery. I did one on our second cycle post surgery which also failed. Since I ovulate on my own, we have been trying naturally without medication.

Taking a GLP-1 now because I don’t know what else to do except IVF. I also do castor oil packs between my period and ovulation, and I wear socks at most times to keep my uterus warm.

Please, is there anything else I can do before pursing IVF? We will have a consult later this year.

Dx with stage III endo back in April during my excision surgery. She excised it all and drained three small endometriomas (2cm on R and two 3mm on L). I have also have had three chemicals. All before my surgery.

I have done extensive testing that all came back negative/normal:

AMH, AFC, FSH, estradiol, progesterone, LH, prolactin, testosterone, vitamin D, full thyroid panel, RPL testing, HSG, hysteroscopy, endometrial biopsy for chronic endometrITIS and EMMA/ALICE, semen analysis and DNA fragmentation, NK cells, TNF-a, IL-6, APS, ANA, CA-125, iron/ferritin/B12, and fasting glucose/A1C/insulin…

5 failed rounds of Letrozole, trigger shot and TI, and two failed IUIs with Gonal-F with trigger. 4/5 Letrozole cycles were before surgery. I did one on our second cycle post surgery which also failed. Since I ovulate on my own, we have been trying naturally without medication.

Taking a GLP-1 now because I don’t know what else to do except IVF. I also do castor oil packs between my period and ovulation, and I wear socks at most times to keep my uterus warm.

Please, is there anything else I can do before pursing IVF? We will have a consult later this year.

Also, I take progesterone suppositories in my luteal phase due to endometriosis and excision surgery. I am guessing this would inflate my results. Does anyone else take progesterone and still track?

Has anyone had a normal/negative HAG, but then a few months later was told dye only spilled from one tube during surgery? My excision surgeon wasn’t really worried since I had a normal HSG. She didn’t want to manipulate the fallopian tube too much as she was worried it could have been damaged.

I did conceive in late January (chemical) from a follicle in my left ovary. So if this is a true change, the block tube would have had to happen between Feb and March.

Spiraling as I am currently ovulating and it’s on the left side and wondering if we couldn’t even conceive this month if it was blocked.

I underwent stage III endo excision on 4/17. I am now in my fourth ovulation post excision. My first two were painful (especially the second one as I was using fertility medications). Last month, I had 0 pain or bloating, but unfortunately this month, I am going 24 hrs with the ovulation dull pain. Whenever I walk I feel like I can feel my ovary moving. To add, the month previously and this month I did not use any fertility meds.

This is the same ovary that I had extreme pain on the second month.

What does this mean? My doctor excised all endo and drained two 3 mm endometriomas on my left ovary (the one with the pain) and drained a 2cm endometrioma on my right.

Hi all! We are at 18 cycles of trying. This month, I chose to try Inito. I ovulate on my own, have had three chemicals in the past and I had stage III excision on 4/17. This is our 4th cycle post surgery. My chemicals were before my surgery.

Has this helped anyone conceive? Husband’s repeat semen analysis is really good. Waiting on his repeat DNA frag (his was 19% in the past). I have had extensive hormone testing and immune testing, all normal.

Hi all. I never had super heavy periods to begin with. But I am on cycle four post surgery and the period is quite light (like only needing to change a pad once a day for a night time pad - still not fully saturating a pad), or using 1-2 tampons a day and then using a pad and nothing is really showing up. My 14dpo test was negative so this must be a true period (bright red and crimson color with some dark patches). I was on progesterone suppositories.

I’m confused. Is this a bad sign for fertility? My period also didn’t hurt as bad before surgery or the few cycles post surgery (which is nice!).

Hi all. I never had super heavy periods to begin with. But I am on cycle four post surgery and the period is quite light (like only needing to change a pad once a day for a night time pad - still not fully saturating a pad), or using 1-2 tampons a day and then using a pad and nothing is really showing up. My 14dpo test was negative so this must be a true period (bright red and crimson color with some dark patches). I was on progesterone suppositories.

I’m confused. Is this a bad sign for fertility? My period also didn’t hurt as bad before surgery or the few cycles post surgery (which is nice!).

I have seen so many women say we have done everything and now we have unexplained infertility and need to go through IVF.

But, did you know silent endometriosis makes up 30-50% of “unexplained infertility”? The only true way to know is through a diagnostic lap, but there is a screening test you could do.

Before you go through IVF, please please please consider an endometrial biopsy to test for these three things:

Chronic endometrITIS (CD138) - can take antibiotics if positive.

Uterine microbiome issues (EMMA/ALICE) - can improve the uterine microbiome with probiotics/diet.

Uterine inflammation (Receptiva) - if positive, you like have endo and IVF will not work if you have an inflamed uterus and pelvis - you either could undergo a dx lap with an endo excision specialist or medical suppression for 3 months before transfer.

Also, a vaginal microbiome (you can order Juno and do this one at home) - ureaplasma can be treated with antibiotics and BV with boric acid. IVF bypasses this of course, but something to consider.

Your partner should undergo a DNA fragmentation test on top of a standard sperm analysis! Male factor issues are a big cause for infertility.

Parental karyotypes. A parent could have a balanced translocation that could be causing early embryo loss. This would be helpful to know prior to IVF to look out for w/PGT-A.

Back story - I have endometriosis and have had three chemicals. If I didn’t do the receptiva, I would not have know how inflamed I was (I did have an endometrioma so I knew I had endo but not how inflamed I was as women can have successful pregnancies with an endometrioma) and if we pursued IvF, it would have been so much money for it to likely fail.

Decided to have a diagnostic lap with an endo specialist and was dx with stage 3 endo. Our chances to conceive have greatly improved. IVF is still on the table for future, but we are trying naturally now. To add, we have done so many medicated cycles. Everything was perfect but all failed or was a CP thanks to untreated endo.

Hi! I have endometriosis, stage 3. Excised on 4/17. This is now our 17th cycle trying. I didn’t know I had endo until 5 months into TTC (ultrasound found an endometrioma).

After that finding (June 2025), we immediately went to a fertility clinic. Many failed medicated cycles and three chemicals (two natural and one with a medication), and still nothing yet. All of this led me to have the lap in April of this year (excised all endo and detained my 2cm endometrioma). Unfortunately, we have not been successful post surgery yet. On my 3rd cycle since.

Besides the surgery, my husband had a SA and DNA fragmentation. I had a hysteroscopy w/ D&C during my lap (normal), HSG in Dec 2025 (normal), relatively normal labs (working to optimize some with my naturopathic doctor - no insulin resistance, good A1C, normal thyroid, hormones as good), EMMA/ALICE (normal uterine microbiome), CD138 (negative for chronic endometrITIS), vaginal microbiome (a little bit of ureaplasma so my husband and I are taking doxy), did a GI map in August 2025 (lots of GI issues - cleaned that up and no longer have pain). We both have normal karyotypes, I had a normal RPL panel, normal NK cells/IL6/TNF-alpha (no systemic inflammatory concerns). I take baby aspirin and progesterone suppositories during my luteal phase (hasn’t helped us conceive/still lost a pregnancy on this combo).

I am trying to prioritize any-inflammatory foods (but I’m not perfect). I have reduced my alcohol intake and caffeine as well.

I don’t know what else to do. I’m lost. We have exhausted all the diagnostic testing we can do. Not sure if we should even try more medicated cycles. I would really like to avoid IVF, but it’s not off the table. Does anyone have any other suggestions?

Is it normal for your periods to be the same level of pain if not slightly more 10ish weeks post surgery? This is my third cycle. I know I ovulated from two follicles on my left but all my period pain is on my right side (where I had an endometrioma and my ovary was tethered to my pelvic wall). The pain is lower right side (still sometimes have the shooting down the leg pain) and lower back on the right side. Is this normal?

Is it normal for your periods to be the same level of pain if not slightly more 10ish weeks post surgery? This is my third cycle. I know I ovulated from two follicles on my left but all my period pain is on my right side (where I had an endometrioma and my ovary was tethered to my pelvic wall). The pain is lower right side (still sometimes have the shooting down the leg pain) and lower back on the right side. Is this normal?