Is Pregnancy Possible?

[Millypo]

Hi, I have a complicated history of severe endometriosis treated with low estrogen pills for years, Lupron and left oopherectomy.  I also have developed autoimmune disease, mild pulmonary hypertension and adrenal insufficiency perhaps due to pituitary microadenoma.  I was in menopause for the last few years, I thought, but stopped HRT recently due to effects on circulation and pulmonary hypertension.   My periods returned to normal and FSH measured in the normal range.  My husband and I thought perhaps we could have a baby, but recently the endo pain has returned.  A recent ultrasound revealed several endometriomas,  a fibroid displacing my uterus, a possible polyp and corpus luteum cyst.  Also, following this ultrasound my Day-3 FSH was measured at 42.   Is pregnancy possible at all given the above?  Also, I am wondering what to do about the other problems.  None showed up on last year's ultrasound.  What tests should I have next, any?  Also, if pregnancy is not possible, is hysterectomy probably the best route?  Thanks.

[Millypo]

Thank you for your response.   A fertility specialist/reproductive endrocrinologist is the one who ordered the tests.  I just want to make sure I know what to expect before I talk to him again.   I think it will be easier to accept that way.  As for the donor egg option, my husband and I have talked about that but are not thinking it would be worth the risk.  I have to take a large dose of Cartia XT to control my PH and if the PH worsened during pregnancy and the CCB wasn't effective enough, I'd be in trouble.   Might be worth the risk if we could have our own child.

Thanks again for answering.  

    

[Keith Downing, MD]

Hello,

With respect to pregnancy a discussion with a reproductive endocrinologist would be helpful.  A day 3 FSH of 42 means you would almost certainly require IVF with a donor egg.  With the medical problems you have, you and your husband should think long and hard about whether carrying a pregnancy is in your best health interest.  You may want to think about adoption if you haven't already.

With respect to the endometriomas and uterine fibroid, the type of intervention all depends upon whether you are symptomatic or not.  Talk with your ob/gyn about the risks of surgery versus medical mgmt versus doing nothing.

Best regards,

Dr. Downing