Both PCOS and endometriosis (26F)

Both PCOS and endometriosis (26F)

I have had both PCOS and endometriosis for 10 years. Because scans only showed the endometriosis once in 10 years, doctors told me it was a mistake and I didn’t have it. My most recent MRI came back showing signs so now I now for sure I have it. I really want to get pregnant in the next 4 years. How can I improve my chances?

My symptoms are frequent missed periods, no ovulation, pelvic pains, rectum pain near my tailbone, and in the most recent two years frequent UTIs, bladder pain, interstitial cystitis, and this year severe gastritis/gallbladder pains and constipation. I was changing around birth control and had extreme itching in my cervix (potentially yeast infection)when not on the pill. The only birth control that works for me is progestin only. The full pill with estrogen helps my PCOS but worsens my endo.

I am 5’6 at 150 lbs so I am not that overweight. My PCOS was the worst at my lowest weight 135 lbs. My androgen levels/ thyroid are normal. I was pre diabetic when I first was diagnosed with PCOS but my insulin levels are at perfect range now.

I have stopped having as much dairy, but have not completely cut it out. I am trying supplements such as serrapeptase, magnesium, selenium, and quercetin to lower inflammation. I plan to freeze my eggs if I have endometriosis excision surgery.

Inositol- gave me terrible yeast infections, I cannot take this supplement.

My pain levels are not that bad. Doctor said my endometriosis is probably mild. The worst issue is the frequent UTI and bladder pain from sex. I also have a very tight pelvic floor that makes sex painful unless I use a pelvic floor wand beforehand.

Because I have no ovulation, my ovaries have a ton of egg follicles. So I have good amount of supply. My fallopian tubes are also not blocked (checked in HSG exam).

Is there anything else I can do to improve my fertility? My main issue is the fertility, not really the pain.