Pain, infertility from adenomyosis, cyst. Treatment?

Question

Hello doctor,

I am 34 years old, and I am suffering from severe endometriosis, adenomyosis, and ovarian cyst, it is very painful, which caused infertility. Please help.

Answer 1

Hello,

Welcome to icliniq.com.

Your question is on a very vast topic. All the problems you mentioned have endometriosis, an estrogen hormone-dependent condition. I mean to say, you will have these as long as you have periods, that is as long as ovaries are functioning. Treatment depends on what your primary need is.

1. If infertility is the main issue have a serum AMH (anti-mullerian hormone) and day three serum FSH level, to confirm how many eggs or follicles are left in your ovaries. Endometriosis eats into the ovarian tissue, so the risk of follicles losing. If normal, then have the cysts and fibroids removed, if they are more than 2 inches, have two to three cycles of hormone suppression, to clear unseen endometrial deposit. Followed by ovulation induction with or without intrauterine insemination (IUI) or go ahead with in vitro fertilization (IVF). At the age of 34 years do not take risks. Once gone eggs cannot be replaced. The best treatment for endometriosis and adenomyosis is to stop the period, and the best way for that is pregnancy.

2. If the pain during periods or sex is a problem, or bleeding is excessive, have a hormonal suppression. That will clear all your problems. I hope I have clarified your query, do write back if any more questions.