Endometriosis and IVF

[Anonymous]

Do you ladies think having a lap done before doing an IVF cycle is worth it? I have a gut feeling that I may have endo but my RE keeps telling me that even if I did doing IVF would bypass it and that doing a lap won't really benefit me. Is this true?

[Anonymous]

In my experience, the fertility drugs can make severe endo that much worse (I have stage IV, very aggressive). I had a laparoscopy (diagnostic) followed by a laparotomy before I did IVF. The surgeries helped clean up bowel and bladder issues, and made the fertility meds more endurable. BTW, IVF did work for me!

There are some great docs around here, and this seems to be one topic that people can't universally agree on. Like I said, the surgeries did a lot to improve my quality of life. On the other hand, I have seen studies that have concurred with your RE. I don't think there is an exact right answer on this one.

Good luck!

[Anonymous]

OP here....can I ask what symptoms you have? I feel like I had a poor response to stims which I have read can be caused by endo. Also there are times when I sit down abruptly where I feel a sharp penetrating pain inside. Sometimes I have that same pain during sex...its the feeling of (excuse TMI) being pentrated too deep? I don't have painful periods and they did not see any sign of endo on any of my ultrasounds which is why my RE doesn't seem to think I have it. I'm worried that if I do that it can impede with implantation.

[Anonymous]

I was in the same situation and was told my my RE that I didn't have it, or that at least it wasn't around my ovaries b/c if it was it would definitely show up on a sonogram, and therefore would have no affect on my fertility. I had always suspected I had endomitriosis, but never realized its implications on TTC until we started having trouble. Long story short, I did have stage 2 endo and it was surrounding my left ovary (which consistently responded poorly to iui stims.) We did IVF 2 cycles later and I responded really well (11 good embryos when all was said and done) and I am now 22 weeks pregnant.

There is no way to measure whether or not the Lap helped, but I believe it did. I have definitely found, like the PP, that each doc has their own opinion on this, but if you have a feeling about your body I'd go with it. If you are like me, if I would have had a failed IVF w/o a Lap first, I would have kicked myself and wondered if it could have helped.

Good luck!

FWIW, I found Dr. Muasher and Dr. Sacks very receptive to having the Lap done.

[Anonymous]

12:56 here: Regarding my symptoms. And, yes, this will be TMI for some people, but here goes:
*diarrhea with every period (endo on the bowel)
*short luteal phase (discovered through charting before endo was officially diagnosed); cycles from 14-26 days, average of 23 days
*chocolate/black blood spotting for days before and after period
*inability to empty bladder (endo coating the bladder); for years I felt like I always had the urge to urinate
*constant back pain that I thought was an old sports injury (turned out my pelvic organs were fused together and stuck to the back pelvic wall)
*sometimes painful intercourse
*most of the time I did not have severe cramps with my period; however, there were two months when I had pain so severe I would wake up screaming and sweating...and for a week or so after my period, I felt like somebody had just kicked me in the stomach with all their might
*before it got really bad, several chemical pregnancies -then I couldn't seem to conceive anymore
*when sonos were finally performed, I had huge endometriomas on each ovary, that doubled in size within a couple months

My bladder, bowels, ovaries (and other parts) will never be the same again, but I will say the surgery alleviated the diarrhea issues and the bladder issues -and it's amazing how much those were impacting my life. Since I woke up from my laparascopy, I have not had that backpain -I felt like I could sit still comfortably for the first time in years. Unfortunately, the endometriomas on my ovaries were so aggressive, that they popped right back up and continued to double, so we went straight to a laparotomy two months later. My RE feared that with the rate of growth, the fertility drugs would do a lot of harm. I can't comment on my response pre-laparotomy, because I never used injectibles until afterwards. I was a poor responder, but being just over 30, I had high quality eggs. There are protocols that do help a lot of us poor responders, so, though, we would love to produce more eggs, there is no reason to despair.

My symptoms were ignored by a GYN for a long time. I would recommend Dr. Rifka at Columbia Fertility. Thanks to his surgical abilities, my quality of life has been greatly improved. After my first full IVF cycle, I am expecting a baby this summer. I credit the laparoscopy/laparotomy under Dr. Rifka for this.

[Anonymous]

Endometriosis is such a hard disease to diagnose. And, you have to learn to be ultra proactive in your own treatment. I was first diagnosed in 2005 via lap (diagnosed as Stage 2, but since recently seeing an RE, found out that it was Stage 4). After nearly 18 months of Depot Lupron (temporary menopause), the symptoms came back nearly seven months after stopping the medication. Fast forward to this January when we began to see a very reputable RE, who ordered a second surgery in March. I had the surgery completed by my gyn in March and we were scheduled to head to IVF in June (ob/gyn found that right ovary adhered to back uterine wall, but all in all, likely Stage 2). At any rate, lo and behold, I am now pregnant (9 weeks) and thus conceived nearly two weeks after the surgery. I know I am very lucky and that the surgery may/may not have helped, but I think for such a minimally invasive surgery, it is exceptionally helpful in the areas of diagnosis and pain relief. I do not know if it helped me to conceive, but at this point, I can only think that it did (although unrelated, the egg by which I conceived came from my left ovary versus the operated-on right ovary). My husband and I had tried for nearly a year so we were onto IVF before our surprise. At any rate, this is just my experience, but I hope that you can find some answers in your own journey. It's tough; hang in there!