After Laparoscopy for Endometriosis: Last Decapeptyl Shot or Fertility Treatment Right Away?

One week after my Laparoscopy, we paid our ob-gyne / fertility specialist (Dr. S) a visit last October 11, 2012.

She told us that even though she had successfully removed the chocolate cyst (endometrioma) from my left ovary and scraped some blood clots surrounding it, that didn’t mean that I’m already free from endometriosis. It can recur at any time, especially when my period starts again (my Decapeptyl shots before the procedure stopped my periods for months).

Yes, surgery (i.e. laparoscopy)  is just a way of managing endometriosis. Apparently, no treatment could permanently get rid of it.

She discussed my possible options:

1. Finish the course of Decapeptyl shots
– If I would be able to finish my course of Decapeptyl (one shot remaining), there would be a good chance that my endometriosis wouldn’t recur soon. If I’m going to take my last shot, my periods and ovulation would stop again for two to four months. In short, no chance of getting pregnant within that period.

2. Start with the fertility treatment right away
– According to her, this is possible. But the downside is –  there would be a big chance that my endometriosis would recur soon.

Honestly, I was a little disappointed. Before entering the clinic, I was looking forward to receive new set of prescriptions for my fertility treatment, not for my endometriosis. In the end, my husband and I finally decided to choose the first option – finish my Decapeptyl course.

For the record – I never enjoyed the side effects of Decapeptyl. Aside from stopping my menstrual periods and ovulation, this drug also leads to weight gain and decreases libido.

I just focused myself on the bright side of this option: Taking this drug will only be equivalent to 2-4 months of suffering. But if I wouldn’t take this shot and my endometriosis would recur again, that would possibly be equivalent to years or even a lifetime of suffering from not having a child.

Five months had passed. My period started again during our last day of vacation in Coron, Palawan (March 21, 2013). We paid Dr. S a visit the next day.

My Laparoscopy Procedure for My Severe Endometriosis

To finally remove the large chocolate cyst growing in my left ovary, I was scheduled to have my Laparoscopy last October 4, 2012. The days leading up to my surgery were very stressful. I had to lose weight, a lot of weight, in less than 30 days. From 145 lbs, I managed to lose 29 lbs before the surgery.

Two days before the surgery were the most painful of all. I was told to be in a “liquid diet” – only soups, fruit juices, water, etc. One day before the surgery, I had to take Dulcolax so I could poop before the surgery and Evening Primrose Oil (as vaginal suppository) to “soften” my cervix and prepare it for the operation.

The “Laparoscopy Day”

Everything went smoothly as planned. I wasn’t allowed to eat anything so we went straight to the hospital to prepare myself early for the laparoscopy. 2 kinds of Enema and a skin test were done before lunch time. At exactly 1:00 pm, they finally took me to the operating room. I was very nervous. I was begging everyone to help save my left ovary. After a few minutes, a nurse came to me and injected something in my IV. That was my last memory.
I woke up while they’re taking me to another room. I was very dizzy, maybe because of the anesthesia. I felt my wounds and stitches, and they were like burning my skin inside and out. There was also an odd pain in my throat that I couldn’t speak clearly. That was when I realized that the laparoscopy was done.
I immediately looked for my sister (since she’s also a doctor and a former classmate of the owner of the hospital, she was able to assist me inside the operating room). I asked her about my left ovary. It was saved! Although the cyst was already in its “critical size”, they were able to remove it without removing my left ovary as well. The procedure took 5 to 6 hours.
I was discharged the next day. Dr. S positively told me that we can start “trying” again after two to three weeks. I was also instructed to visit her again after seven days so she can check the stitches.
Despite the fact that I couldn’t move because of my fresh wounds, I was very happy. I already started imagining myself pregnant. What clothes should I wear? When should I start shopping for baby stuff? I knew from that moment that this time, nothing would stop us anymore from having a baby.
What happened next? Find out on my next post.

My Polycystic Ovary Syndrome and My First Fertility Treatment

As I had mentioned on my About Me page, my husband and I were already trying to have a baby since 2005 – with no luck. I had a total of 2 miscarriages – the first one happened in 2006 and the second one in 2010 (I had no idea that I was pregnant since I always have irregular periods).

Our first fertility treatment started on 2007 after consulting an ob-gyne (let’s just call her Dr. D for now) for my continuous vaginal bleeding. She did a transvaginal sonogram and she found out that I had Polycystic Ovary Syndrome (PCOS). The worse thing about it was that both ovaries were affected. I was devastated, especially when she told us that there’s a large possibility that my condition might be the reason why we’re still childless. She also conducted a sperm analysis on my husband and everything’s normal (lucky him!).

Dr. D immediately prescribed me with Duphaston to stop my bleeding. Had to take it for five (or ten?) days and on the third day of my period, she prescribed me with Clomiphene (Clomid) – a fertility drug. I was also instructed to take a pregnancy test the following month.

My first month of fertility treatment failed. They were wondering why I couldn’t produce eggs despite the fact that I’m taking Clomid. Dr. D increased its dosage and told me to take Metformin once a day everyday (for my PCOS) during my second month of treatment. Everything failed again. Same thing with third and fourth month.

She started to introduce a procedure called Tubal Cannulation, wherein she would be able to flush my fallopian tubes to check if there’s a blockage or something. That procedure was worth P7,000 at that time and since we were not yet ready to gamble our “itsy-bitsy” savings, we decided to take a rest and try again without the help of any fertility treatments.

3 years had passed and my womb’s still empty. Out of desperation, I tried to self medicate with the drugs Dr. D prescribed me during our treatments without my husband’s knowledge. After two months, I had my “Year 2010 Miscarriage”.  I had no idea that I was pregnant since my periods are always irregular.

We went back to Dr. D with the palm-sized lump of blood that came out during (what I thought was) my 6-hour dysmenorrhea attack. She then confirmed that it was indeed a miscarriage, and the probable cause might be my hormonal imbalance (hormonal imbalance and PCOS are sisters). She instructed me to continue taking Metformin everyday.

Was I able to cure my PCOS with Metformin? Did I finally get pregnant after this? Find out on my next post.

Friendly Reminder:
Do not try to self medicate with the drugs mentioned in my post. Treatment for PCOS depends on the severity of the condition. It is always important to consult your doctor first before taking anything.