Patient's Query
Hello doctor,
Husband is 39 and wife is 38. Married for the past 11 years. Late pregnancy planning. Open myomectomy, right ovarian cystectomy, and adhesiolysis were done three years back. Conceived normally two years back with low AMH 1.34. CS a year back. Congenital heart disease - aortic stenosis, large PDA. Aortic valvotomy and PDA ligation surgery were done. The child died after 71 days. Trying to conceive with Letrozole, CoQ 10, Fol XT, Prastova SR, etc. No result. Severe pelvic pain and cramping for the last four months. No result in Drotin, need to take Jonac Suppository. CA 125 Value 55.6. Husband semen analysis and culture are normal. AMH 1.1, AFC 4 to 5. Small fibroids found in the uterus. A follicular study was done in the last six months. Regular ovulation on day 12 to 13. Consulted fertility doctors and gynecologist. Suspected endometriosis. Advised Lupride injection followed by Laparoscopy, IVF. We need advice.
Hello,
Welcome to icliniq.com.
Keeping your history in mind, it is suggested that possible endometriosis or PID which can be the cause of raised CA125 should be ruled out with a diagnostic laparoscopy and peritoneal lavage for culture and possible malignant cells (if any, ovarian). This is mandatory to justify rising CA125 levels which indicate epithelial ovarian cancer. Once that is clear, then you should ideally opt for IVF- ICSI (intracytoplasmic sperm injection) procedure with wife ovum and husband sperm pre-genetic implantation diagnosis (PGD) of the embryo to rule out any age-related congenital anomalies followed by embryo transfer and maintenance of pregnancy on progesterone support and IVF drugs.
Considering that fibroids usually do not support IVF pregnancy but they are presently small and once implantation and growth occur, they shall thin out, so still best is IVF. If the cause of raised CA125 levels turns out to be malignant, then pregnancy should not be opted for and treatment for malignancy would take priority.
Same symptoms don't mean you have the same problem. Consult a doctor now!
Related Questions
I have severe period pain. Is it because of endometriosis? What is the treatment?
Can IVF be done in a patient with endometriosis?
Can I conceive naturally after endometriosis surgery?
In Vitro Fertilization (IVF)
Fourth ultrasound after IVF has no signs of fetal pole. Please help.
I am having IVF failure even though there are good stimulation and embryo production. Why?
Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website. Read our Editorial Process to know how we create content for health articles and queries.