Becoming a mother after Endometriosis diagnosis
Endometriosis is present in about 35% of women who have fertility problems, but this does not necessarily mean that they cannot become mothers. Here is another real case of Endometriosis that we have treated at the Clinica Fertia with a happy ending. A case in which we want to emphasize once again the importance of carrying out a personalized diagnostic study and treatment to increase the chances of pregnancy in patients with Endometriosis.
Endometriosis case file
The 38-year-old patient came to our fertility clinic with a history of miscarriages after a twin pregnancy, she provided a study of Thrombophilias (propensity to develop thrombi), with the presence of high ANA (Antinuclear Antibody) titers, associated with recurrent spontaneous miscarriages and with primary infertility), so the hematologist prescribed prophylactic heparin.
During the first visit, the patient also brought the results of a double gel MRI of the pelvis, which showed a 2cm Endometriotic implant in the round ligament, a Myoma of 3cm, and the presence of three Endometriomas of 12mm in the left ovary.
Diagnostic study
After an ultrasound study was carried out in our fertility clinic, we confirmed these findings. We performed a count of Antral follicles obtaining a result of 8 (the count of Antral follicles is an important indicator of the ovarian reserve, which in this case was low), and we appreciated a left-border Adenomyoma with Hyperrefringent linear striations, econegative islets and a globular and asymmetric uterus, all this suggested the presence of Adenomyosis. The patient presented an AMH value of 1.54 (anti-Müllerian hormone and the seminogram of her partner did not present pathological findings.)
Fertility treatment program at Clínica Fertia
The patient had undergone three cycles of conjugal insemination (with her partner’s semen) without success in another clinic. They also performed an In Vitro Fertilization cycle, with which they obtained 3 oocytes, and subsequent transfer on Day 3 of quality B embryo.
Due to the compromised ovarian reserve and previous cycle with low response, an IVF cycle was programmed in our fertility clinic after impregnation with androgens and following a stimulation regimen with Corifollitropin 150IU and FSHr and LH r 150 IU, short cycle with antagonist analogues of the GnRH.
A total of 7 oocytes were obtained, which were subjected to prolonged culture in incubators with low oxygen concentration and two embryos were preserved on day 6. We recommend the Double stimulation strategy (duo stim) to the patient in order to obtain a greater number of oocytes and increase her chances of success.
After the second stimulation, 5 oocytes were obtained, they were transferred to prolonged culture, and as a result we obtained 4 blasts of good quality on Day 5.
Before proceeding to perform the transfer, we recommend that the patient undergo a hysteroscopy to be able to make a better assessment of the uterine cavity, when performing it we appreciated a slight narrowing in the left horn of the arcuate cavity due to the compressive effect of the Myoma / Adenomyoma. Two months of GnRh analogs in combination with vaginal probiotics were indicated with the intention of improving her Adenomyosis and reducing the size of the Adenomyoma.
Subsequently, the Cryotransfer in a substituted cycle was programmed in addition to tinziparain and ASA 100 (to prevent thrombi), we carried out a progesterone control one day prior to the adequate transfer 13.06ng / ml and the blastocyst transfer was carried out on Day 6 with an evolutionary gestation result.
A beautiful, healthy baby girl was born to term by cesarean section. The happy ending that this patient and her partner had fought so hard had finally arrived, their dream of parenthood had become a reality.
The importance of carrying out a detailed study of each case
Once again, the team at Clínica Fertia want to highlight the importance of carrying out a detailed study of each patient. In this case, the evaluation not only of the patients Endometriosis but also the diagnosis and treatment of her Adenomyosis, as well as an adequate pattern of stimulation have allowed this patient to fulfill her dream of becoming a mother.
Our team encourages you to never give up hope, if you have been trying to get pregnant for a while without success, have undergone other fertility treatments before or have been diagnosed with Endometriosis, we would love to hear your story.
Request a completely free, first appointment at the clinic or online and find out how we can help you.
