- There was Stage 3 endometriosis around my ovaries, and my right ovary had a large endometrioma, which is a fluid-filled cyst. He explained again that my ovaries were immobile because they were stuck to my abdominal wall.
- Because the endometrioma on my right ovary was so large, the ovary looked pretty beat up after the cyst was removed. He said they had to remove the whole cyst, including its lining, so there is always a risk that a few eggs are taken with it. (Sad, right?) If they didn't completely get the cyst out, though, it would return in a month or two. Because removing of the cyst causes bleeding, he had to cauterize the outside of the ovary, so it looked black and misshapen. However, the amazing thing is that the ovary will heal itself between 2 and 4 weeks, so there's a good chance at this moment it's looking fine.
- There was a little bit of endometriosis on my bladder wall which would be at a stage 1. It was interesting to see the difference between the two: my ovaries were covered with endometriosis, but my bladder had only tiny dark dots here and there.
- My uterus was healthy, and both of my fallopian tubes were clear, as well. They did the same HSG test that I had done in 2009, which at that time had come back with the results that one tube was clear but one seemed slightly blocked. This was good news to hear that both looked great.
- Some other interesting things: progesterone can control the spread of endometriosis, so that is why a pregnancy will at least stall the endo from coming back. This could also explain why birth control is used as a controller for endometriosis and often helps make severe menstrual cramps milder. The monthly period itself is a contributor to the problems of endometriosis since not all of the blood leaves the body. Another weird thing: apparently, the "make-up" of blood that a woman with endometriosis has during her period is different than another woman. Crazy, huh?
- I also asked him if the treatments could have made the endometriosis worse, and he said, theoretically, that would be the case. The endometriosis thrives on estrogen, and the treatments increase the levels of estrogen a person has. However, he wasn't too concerned about this since the treatments are done rarely and for only a short period of time. I do wonder, though, if that visit to the ER two summers ago was the beginning of that cyst. Just speculation, of course...
So that's the explanation of what he found. Of course, we were concerned with one main question: How will this affect our ability to conceive??
- Because the endometriosis was as advanced it was, it will return. It could return in six months or a year, but there is no doubt that it will come back. Another laparoscopy really isn't an option because multiple laparoscopies will have negative effects on my ovaries and the quality and production of eggs.
- He has found that with women like me, there is about a 40% chance (or 1 in 3) that they get pregnant without treatments within the year.
- He would recommend that we consider a few cycles of treatments and IUIs because women with endometriosis typically have lower quality eggs. The clomid and ovidrel I have taken help produce more follicles (so more chances that my left ovary will produce an egg, which would be the better option) and higher quality eggs and ovulation. The only downside with the treatments and IUI is the cost and a slightly increased chance of multiples.
Overall, the appointment was positive. Of course, it was a bit disheartening to hear that the endometriosis will come back, and that there's no way to really "cure" it. And I don't like this whole "race against the clock" thing, but I guess all women have some clock they're having to think about. Nevertheless, it seems my chances of having a baby have just sky-rocketed! Our main prayer concern right now is if and when to do the treatments. My doctor wants to make sure I have one normal cycle, but after my period comes next month, we can begin an IUI cycle or can choose to wait. Neither of us has any idea of what we want to do right now. The one plus is that our new insurance does have a small amount covered towards infertility, so there may be a chance one or two IUI cycles could be covered.
It feels great to have the surgery done and to have met with the doctor and talked about Robby's and my immediate future. What an exciting beginning to 2011!