Advice on fertility options for fibroid uterus w/thick endo stripe

I’m a 33year old who has had 54 (yes, the doctor counted them) fibroids removed two yrs ago this upcoming Nov…I was told according to the sonogram that there were 6-9 fibroids at that time. The past 6 months my periods consist of clotting and crampping which is due to 3 fibroids. I had a U/S last week due to concerns from my doc (internal medicine) and I about not being able to get pregnant for the past year. The U/S noted the following: enlarged 2.2cm follicle w/in the right ovary, normal left ovary, fibroid uterus (each about of the three fibroids measure 2.0 cm)w/thickened endometrial stripe at 2.0cm in thickness. Scheduled to see a gyno this week and all of my research points to post-menapausal woman, possible cancer and/or endometriosis or that I’m not ovulating. Very concerned since my mother had a hysterectomy at 35-36 yrs age. In addition, have had consistent lower back pain and cramping since my last period on Aug. 13th. Any advice is greatly appreciated.

Dear Kseto-
We must applaud your doctor for the first myomectomy…most would have not taken the time to remove 54 tumors.
Chances are you may have Adenomyosis (along with your remaining fibroids), which is endometriosis of the uterus. This would explain the clots, cramps, low back pain and thickened endometrial stripe. Fertility could also be affected by the adhesions and scarring from your first surgery. IF you have adeno, you need to get it removed or the symptoms will continue to progress and worsen. Unfortunately, most often when adeno is removed, fertility options are limited.