From the Guidelines
It's too early to lose hope as a negative home test at 6 days post-transfer doesn't definitively indicate failure. If this transfer is unsuccessful, consider consulting with your reproductive endocrinologist about adjusting your protocol. Your current approach is comprehensive, addressing endometriosis with excision surgery and Lupron suppression, improving uterine receptivity with sildenafil and probiotics, and reducing inflammation with prednisone. For a next attempt, your doctor might suggest continuing these treatments while potentially adding or adjusting medications like metformin (which can improve implantation rates in some patients) or modifying your immunosuppression regimen.
Key Considerations
- The statistics for PGT-tested embryos are generally favorable, with success rates around 60-70% per transfer, even with endometriosis 1.
- Your lining thickness of 8mm is optimal, and the use of Lovenox (blood thinner) and prednisone (anti-inflammatory) addresses potential blood flow and immune issues.
- According to the American College of Obstetricians and Gynecologists, surgery for women with endometrial pain is associated with significant reduction in pain during the first six months following surgery, but up to 44 percent of women experience a recurrence of symptoms within one year 1.
Next Steps
- Consider consulting with your reproductive endocrinologist about adjusting your protocol.
- Potentially adding or adjusting medications like metformin or modifying your immunosuppression regimen.
- Remember that even with perfect conditions and tested embryos, implantation involves complex biological processes that aren't completely controllable, and sometimes multiple transfers are needed before success.
Important Factors
- Endometriosis treatment with excision surgery and Lupron suppression can improve outcomes.
- Uterine receptivity improvement with sildenafil and probiotics can also enhance success rates.
- Reducing inflammation with prednisone and addressing potential blood flow issues with Lovenox are important considerations.
From the Research
Endometriosis Treatment and Pregnancy Outcomes
- The use of letrozole for ovulation induction in women with polycystic ovary syndrome (PCOS) has been shown to be effective, with higher live birth rates compared to clomiphene citrate 2.
- Surgical treatment of deep endometriosis, such as full-thickness disc excision, can be an effective alternative to colorectal resection, with better preservation of rectal function and favorable postoperative outcomes 3.
- The choice of surgical technique for deep endometriosis depends on various factors, including the size and location of the nodule, and the patient's overall health 4, 5.
Impact of Endometriosis Treatment on Pregnancy Outcomes
- Studies have shown that women with endometriosis who undergo surgical treatment, such as disc excision or bowel resection, can achieve high pregnancy rates, with cumulative pregnancy rates ranging from 63% to 80% 3, 5.
- The use of letrozole for ovulation induction in women with PCOS and endometriosis can also improve pregnancy outcomes, with cumulative clinical pregnancy rates and live birth rates reported in the literature 2, 6.
Use of Adjuvant Therapies
- The use of adjuvant therapies, such as lovenox and prednisone, in women with endometriosis undergoing fertility treatment, may help improve pregnancy outcomes, although the evidence is limited 2.
- The addition of metformin to the treatment regimen may also be beneficial in improving insulin sensitivity and ovulation induction in women with PCOS and endometriosis 6.
Statistics for Endometriosis and Fertility Treatment
- The chances of a successful pregnancy outcome in women with endometriosis undergoing fertility treatment depend on various factors, including the severity of the disease, the type of treatment used, and the patient's overall health.
- Studies have reported varying success rates for fertility treatment in women with endometriosis, ranging from 20% to 80% 2, 3, 5, 6.