Endometriosis Removal: New Mother of Twins Thanks Paul MacKoul, MD

November 29, 2016

Woman sitting with her two babies on her lap

endometriosis removalFor nearly a decade, Bela, (Vienna, VA) tried every possible path to having a child with her husband. Fifteen fertility treatments across two states, surgery to remove fibroids and scar tissue, supplements, acupuncture, surrogacy, and her next step if she couldn’t get pregnant with her own eggs, was to try a donor.

Endometriosis removal at The Center for Innovative GYN Care was the last attempt before seeking donor eggs.

“Prior to getting the endometriosis removed, none of my cycles were successful. I had been through six IUI cycles and nine IVF cycles. After going through several IVF failures, I sought help of a reproductive immunologist in New York. He indicated that it is very likely that I have endometriosis based on the results from my immunological testing. He also indicated that endometriosis could affect the egg quality and could diminish the ovarian reserve. I did not have any typical symptoms of endometriosis and the disease was not seen during my first 2 surgeries. I was intrigued and decided to consult Paul MacKoul, MD. I knew that Dr. MacKoul being a gynecologic oncologist would have excellent surgical skills to identify and remove silent or hidden endometriosis. I wanted him to do a laparoscopy for me. With so many implantation failures especially after IVFs, I needed an answer.”


Endometriosis can affect the ovaries, quality of eggs, or create toxicity in the lining. Endometriosis experts are better at identifying and removing all lesions, endometriomas and pelvic adhesions (or scars) that can develop from years of inflammation. Not all OB/GYNs are trained to recognize the symptoms or to thoroughly remove endometriosis, often resorting to performing hysterectomies which are not always effective in treating the pain. If lesions or damaged tissue is left behind, it can cause intense pain or infertility.

“I had undergone a laparoscopy and a myomectomy in the past and the surgeon did not find endometriosis. He found my tubes were blocked from scar tissues and recommended that I go with in vitro fertilization to have a baby. I went through 4 IVF cycles in Virginia and 5 cycles at a clinic in New Jersey.”

Ectopic pregnancies occur when the embryo cannot pass into the uterus and stays in the fallopian tube, or implants. These are usually discovered before the 8th week of pregnancy. Even though they are caught in the early stages of pregnancy, ectopic pregnancies are life threatening to the mother, and the baby cannot survive.


“I decided to do one last IVF, my 10th cycle with my own eggs before throwing in the towel. I consulted Dr. MacKoul and discussed my case with him. We decided to do another laparoscopy to take a fresh look at my uterus and tubes. Before doing my last IVF cycle with my own eggs, I wanted to cover all bases. Dr. MacKoul discovered stage 1 endometriosis during the laparoscopy. It was around the ureters. While that meant that I had to deal with another issue that caused infertility in additional to several issues I already had, I was glad to have the endometriosis found and removed! We decided to take a 3-month break before trying another IVF. I knew that endometriosis affects egg quality and I wanted my ovaries to get 3 months rest to make some ‘good’ eggs. On my 10th IVF cycle after the resting period, we got three eggs out of which 1 was mature and 2 were immature. I felt devastated as the number of eggs were fewer compared to the previous cycles. The IVF clinic matured the immature eggs and we got three fertilized embryos. Clinics usually want to transfer the embryos on day 5 but I didn’t want to wait. What if all of them died in the lab? We decided to transfer on day 2 and give them a chance to survive in my uterus which was now free of endometriosis. 2 embryos implanted and gave me my first ever successful pregnancy in 10 years. I realized that it was the quality (of the eggs) and not the quantity that matter. I was convinced that endometriosis was certainly ruining me in the past. I give credit to Dr. MacKoul because without the laparoscopy, I wouldn’t be having my beautiful children.”


“My twins were born early at 32 weeks as I had other issues during the pregnancy. They stayed in the NICU for more than a month. We had a rough start but we all are doing good now. It still feels surreal. Last year around this time, I was completely hopeless. Infertility had swallowed me. I had several failed IVFs, too many infertility issues and several losses. I could never imagine having a baby in my arms. And now I have 2 of them!”

GYN conditions like fibroids, endometriosis, pelvic adhesions, uterine polyps, uterine septum, and inflammation of the fallopian tubes (hydrosalpinx) can affect the healthy trajectory of a pregnancy. Many women who feel they are ready to start a family have difficulty conceiving, suffer through multiple miscarriages, or deliver early putting the mother and baby at risk. And many of those discover that they have a GYN condition that could have been treated. The emotional toll on a woman or couple trying to conceive can be painful.

“There were moments where I would just pull the car on the shoulder and sob. While my friends, cousins and everyone around me had beautiful families, I was failing one IVF after another. I never shared anything about my infertility journey with anyone in real life. Now that I have my 2 beautiful babies, it is much easier for me to talk about it.”


The CIGC state-of-the-art specialists are available at three locations in the DC metro area. Virginia patients can visit the Reston location, and Saturday appointments are available. Maryland offices are located in Rockville and Annapolis.

GYN surgical specialists can often see women sooner because they are focused entirely on surgery. Each patient gets detailed, in depth attention from Dr. Natalya DanilyantsDr. Paul MacKoul and Dr. Rupen Baxi. This personalized care helps patients understand their condition and the recommended treatment so that they can have confidence from the very start. Our surgeons have performed over 20,000 GYN procedures and are constantly finding better ways to improve outcomes for patients.

Book a consultation today with Paul MacKoul MD, Natalya Danilyants MD or Rupen Baxi, MD.


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CIGC-Travel-Map-FBEven if you are not from the DC area, many patients travel to The Center for Innovative GYN Care for our groundbreaking procedures. We treat women from around the world who suffer from complex GYN conditions.

Learn more in our travel program.

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