PERSONAL STORY: RENEE MARIE BERGER-ROCA

I started having discomfort and pain since my first period at 13 and a half. My periods were regular lasting from 28- to 30 days. At 16 I visited a gynecologist here, who just sent me two months of birth control to ease the pain. My mother had had endometriosis so she suspected I had it.

My symptoms were:

• Back pain.
• Heavy bleeding.
• Leg pain (the pain was from a little above my waist to my knees)
• Heavy cramps, I broke into a cold sweat when I had them.
• Pain in my cul de sac.
• Pain while urinating.
• Pain with bowel movement.
• A few times I had nausea and vomiting.
• I spent two days of the month in bed and I couldn’t carry on with my regular activities.
• Frequent heartburn. (I would know I was getting my period because I got heartburn one day or two before)

All these symptoms were present throughout the month but were worse during my period that lasted 6 to 8 days.

In 1990, I visited Dr. James Friedman in Houston TX. Who my mother’s Dr.; he performed a rectal and vaginal tests and immediately suspected endometriosis, he told me I had very thick tissue in the rectal area. Three years later I scheduled my first lap, in July 1993. Since preserving my fertility was the priority he only did a diagnostic surgery considering he diagnosed me with Stage 3 endo, and pelvic adhesive disease. He prescribed two months of Synarel.

Dr. Friedman performed the second lap that same year, in which he removed the endometriosis. He put me on birth control pills, which caused depression and lots of side effects so I stopped taking them for seven months.

When I went back for my yearly check up I was experiencing pain again so he recommended another laparoscopy. Dr. Friedman found more endometriosis and a cyst, and put me on Loestrin Fe 1/20 which I adapted to very well and took for the next 3 years and seven months. While on the pill my periods shortened to 3 to 4 days. I continued experiencing pain, and Dr. Friedman performed a fourth lap and concluded the treatment was working.

In march 1997 I got married and stopped taking the pill; in September ’97 to start trying to conceive, Dr. Friedman told me to go back to him if I didn’t conceive within the next 6 months.

Since I was not getting pregnant I visited him again in May 1998, and he ran a sperm analysis for my husband (it turned out normal), a hysterosalpingogram (it showed open tubes) and a post coital (it showed the vaginal ph was too acid). He sent me home with a Milex Pro-Ception (30 minutes before intercourse) douche for three months, without success.

Dr. Friedman retired and I started seeing a reproductive Endocrinologist, here in my country (Dr. Jorge Gonzalez). He ordered some blood tests, diagnosed me with Poly Cystic Ovarian Syndrome, and determined I was not ovulating. (Blood test information included)

Later in November he performed the fifth laparoscopy which included an ovarian drilling and removal of the recurrent endometriosis. Because of the surgical method, he was able to remove only very little endometriosis and he prescribed Lupron for three months. I was completely pain free during this time. After the surgery he ran the hormonal tests again (Blood tests included) and it all seemed normal.

In June 1999 I started fertility treatments with 100 milligrams of Clomid, and HCG injections. Four months later complimented this with Pergonal injections. The Clomid didn’t work so he started doing IUI from February to April using only Pergonal and HCG.

During the whole time while on fertility treatments I started experiencing endometriosis symptoms gradually:

• Back pain.
• Pain while urinating.
• Pain with intercourse.
• Pain with bowel movement.
• Heartburn.
• Pelvic Cramps, low middle and both sides.

I stopped treatment in June, and immediately the symptoms eased a little.

After stopping the treatments I have started having cramps a week before my period accompanied by spotting and back pain, the most uncomfortable pain is the cul de sac, when I sit down. I am enclosing a symptom chart of the pain and when it occurs that I have been keeping since I stopped the fertility treatments.

Currently Dr. Gonzalez recommends my next step in the fertility treatments be either IVF or GIFT, he is referring me to specialists in the U.S. He suspects the endometriosis might be back. I have not been under treatment for the endometriosis in the last year and nine months.

I need to know if I should undergo a laparoscopy to remove the endo before I attempt any other more aggressive fertility treatment or just go ahead with the fertility treatments (In the U.S.A.).

Renйe Marie Berger-Roca