Unexplained Girls - Laproscopy and IVF?

patchen30 · April 2010

My RE told me before I did IVF that there was no need to do a lap b/c IVF bypasses endo, and I have no symptoms of it (except LP spotting, which may or may not be a symptom according to RE).

Today during our WTF my RE brought a lap up and said that he normally doesn't do one after a single failed IVF, but if it happens again, he would recommend one. He said that there are some studies that show that if you have endo and get it cleaned up it can increase IVF success rates. He said that occassionally couples chose to do a lap before a second IVF considering this.

I said I'd do whatever he recommended, and he said normally he doesn't push a lap after 1 failed IVF. I figured I'd follow his normal procedure then, but I don't want to be stupid about it just b/c I'm ready to get the ball rolling with another IVF.

Has anyone had a simliar discussion with their RE? Thoughts?

georgiagirl1212 · April 2010

Well, I'm not doing IVF yet, but I am basically unexplained and have chosen to undergo a lap. I guess the question comes down to how much you have invested in each IVF cycle. If you're paying oop or otherwise find each cycle to be very stressful, doing all that you can to promote a positive outcome might be worth it. There seems to be some belief that, while IVF bypasses endo, the presence of adhesions can reduce implantation rates.

I've been referred for a lap by my OBGYN (RE can't do it for insurance reasons) b/c of the symptoms I've been having. Also, though, I just want to know what I'm dealing with before considering IVF, and endo is the only possibiltiy that hasn't been explored for us.

BTW, my RE has never mentioned spotting as a symptom of endo (but then, he claims to be baffled by it). My OBGYN, however, feels that it definitely is.

Good luck with the decision.

k-mart · April 2010

I'm not as far as you are, but the only real symptom of endo that I have is very painful cramps. Two of my RE's have said to keep trying without a lap. They didn't think it was necessary because I only have one symptom and they can't feel the endo in pelvic exams.

I really wish there was an easy answer. I would love one myself!

ctbride08 · April 2010

**ticker warning**

We had similar conversations with our RE. DW doesn't have any symptoms of endo but its the only thing left that could explain the IF. We're heading into our first IVF now (and decided to skip the lap) but if its unsucessful, we'd definitely do a lap before another IVF cycle.

best of luck!

PrincessJesci · April 2010

I think my insurance required a lap before IVF because I have a strong maternal family history for endo. I don't have it. If I were in your shoes I would do the lap just to rule out other factors. I couldn't deal with another failed IVF and then think "what if we had done the lap and figured out xyz."

schoolsoutbride · April 2010

Endo is largely unexplained, I think. Yes, it causes blockages. But it may cause other problems too.

My RE, who is very conservative and very against the "lap carousel" that a lot of women are on, suggested I get a lap before my FET b/c my pain was back. Turns out he was right. It was back and worse.

Now if you have no symptoms....it's a tougher call.

Kiki11 · April 2010

I am unexplained and after 3 failed IVFs, my doctor decided to do a hysteroscopy which I definitely credit with the fact that I had successful implantation twice after that when before I had tons of failed implantations/chemical pregnancies. (He found some minor irregularities in my lining and did a D&C to let my lining start fresh) I don't know much about laps, but maybe a hysteroscopy could be a less invasive option?

patchen30 · April 2010

Kiki11:
I am unexplained and after 3 failed IVFs, my doctor decided to do a hysteroscopy which I definitely credit with the fact that I had successful implantation twice after that when before I had tons of failed implantations/chemical pregnancies. (He found some minor irregularities in my lining and did a D&C to let my lining start fresh) I don't know much about laps, but maybe a hysteroscopy could be a less invasive option?

It's tough to know when to draw the line, you know?

I thought about asking about that too...what's the recovery like? I don't think my RE has ever suggested that b/c I've never had a m/c or abortion and my saline u/s (2 of them) have been normal. But I did think about this also.

Stuckinthemiddle · April 2010

I'm unexplained, and my RE said that even if he knew for sure that I had endo, he would be treating me the same way as he is now without knowing for sure. I would personally like to know what the problem is, and I am having to get used to his way of thinking.

I don't have any symptoms of endo though, except for heavy AF, and personally, I think my IF issue is that I ovulate late. I have a regular but long cycle (36-40 days) and I usually ovulate between 22-25. The only time I got pregnant was when I had a trigger with my IUI, so I think I am just releasing my eggs too late.

I don't know what else to tell you, but I get very frustrated when I think about being in this "unexplained" category. Good luck to you and please let us know what you end up doing because I may be right behind you in this situation!

Something is wrong, and at this point it is either

NYC1216 · April 2010

I too have thought about this. I have not asked my RE about it yet because I have no symptoms. I just feel like at this point, I have to rule everything out.

nrjf01 · April 2010

***ticker warning***

I had a lap done after doing one round of injectibles with IUI. I was unexplained and DH had no issues. I am soo very glad that we did. My RE found mild endo and my ovary was attached to my pelvic wall. After the surgery my RE told me that our chances for success had greatly improved. Three months later I finally got my BFP.

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