Hi, I am extremely sorry and understand the pain caused by the disease. many women in my clinic come with similar complaints. For women with grade 4 disease wanting pregnancy, surgery is the best possible treatment. The surgeon tries to remove all visible endometriotic patches leaving the ovaries and uterus. Sometimes there is blood collection inside giving rise to pain as well as the endometriosis surrounds the intestines causing their malfunction and even obstructing them. It is possible to remove all this by surgery. The chances of natural spontaneous pregnancy are low as usually the tubes are involved in grade 4 and ovulation is also abnormal. It is advisable to try and conceive as soon as possible after surgery as pregnancy helps in cure of the disease. If pregnancy is not desired than drugs like GnRh analogues and danazole as well as long term use of certain hormones like progesterone are used to provide relief. Even with them only 50% women get relief while the rest continue to have symptoms. Even then, surgery to remove the uterus and ovaries is the best way to stop progression of the disease and decrease pain. I understand the agony that is being experienced by the patient. I suggest that you reconsider all possible therapies and their limitations before deciding upon further treatment. Hope I was able to help you. Thanks for using HCM. Dr. Madhuri Bagde Consultant Obstetrician and Gynecologist