SO confused-opinions PLEASE =(

I have been TTC for a LONG time now and finally sat down for a consult with the RE today after months of trying and thinking we would decide on a lap....
well i met with the RE today and i'm more confused than ever. He said he's not pushing for the lap but he was explaining it to me in case i wanted to do it. He said the odds of him finding anything wrong yield very low in his mind. He said he thinks if he goes in he won't find anything wrong. I am TERRIFIED to get put under and he said because of that he probably wouldn't push me to it seeing as he has no reason to believe anythings wrong.
He said usually if he sees something weird on the Hysterosalpingogram (spelling is probably wrong)...the dye test...or if i had symptoms, he would be more apt to push me in that direction.
I'm so confused...he said sometimes even if there isn't anything wrong with women when he does the lap, by "blowing" the tubes it clears everything and women end up pregnant a lot faster sometimes. He said in my situation if he goes in and finds nothing wrong, he would suggest IVF...if it's really bad, he would say IVF...and usually if its mild, he will clear it out but it probably isn't the cause of the infertility.
OR he said i can stay on the injectibles, and to make them last longer he can mix those with the femara/clomid...and continue with iui...OR i can jump into IVF. BUT again, he said he's not really pushing for it b.c i  don't present with any symptoms and text book speaking, we should be pregnant....
Im so confused i don't know what to do!!!!!!  anyone have opinions on this?

[Helen72]

My HSG showed I had no problems and I had no signs of endo yet my RE found a different problem.  Of course the only solution was ivf.  If you are going to do ivf you probably do not need a lap.  If you decide to continue with IUI's, a lap may be a good idea just to make sure that everything is OK inside.  It's a very safe surgery.  

Good luck with whatever you decide to do.

[alaskacouple]

I know this is probably a dumb question.... but has your partner been checked out? It is MUCH easier to start with him first.

[JennViv]

Well my husband always has at least 40 or more mil after washing (like 80 mil prewash). His motility is usually 40% or more which they said is good?? Are there any other tests they can do besides a SA? The RE said possibly the sperm cannot penetrate the egg but we wouldn't know unless they do ivf to see if that is the case? (The RE said if they don't fertilize the egg at ALL even after injecting them into the egg, they don't charge for the ivf ).
I am just so confused with all of this and was like a blubbering 2 year old at the RE office today....it's just so hard to know you are right down to the wire and have to make a decision like this. Some things i have read so far say that for IVF, the advances with it are so good now that most women don't need a lap prior to it...i don't know how true this is.

[JennViv]

i guess i should add too....my insurance covers the lap....but doesn't cover ANY of the ivf...no meds, no bloodwork, no ultrasounds-nothing!!!! So I don't even know how to afford this....the RE said they are waiting for grant money that comes in every year but with NYS and the economy who knows how that could work out!

[bree08]

Hi had the procedure to see if my fallopian tubes were open and they were. My blood work and physical checked out. My RE did an ultrasound and found a fibroid inside my uterus. Did they do an ultrasound on you. They can usually see if there is concern from an ultrasound also. I just had the lap a month ago today and it took me a good two weeks to recover. Have you two had IUI's done then too?

[JennViv]

I've had internal ultrasounds if that is what you are referring to? I've had 7 iui's....some with clomid..some with clomid and ovidrel....menopur...bravelle...you name it. I have never really had any major problems or surgeries (had partial thyroid removal years ago-but bloodwork shows that is fine).

[bree08]

Yeah I was referring to an internal ultrasound. That's what I had and they found a fibroid. I hope everything works out for you! Does your RE have any ideas of why the IUI's are not taking? It doesn't hurt to have the lap done When they go in there they'll clean you our really good and check your fallopian tubes again.

[brooklyn_gal]

This is the info I got from my RE.  I also have unexplained IF other than just turning 38.  I've been trying TTC for 2 years +, 2 IVFs, and 2 IUIs with no success.  My RE recently brought up lap as an option as well.

Her findings are that there were two studies done.  One study showed that after a lap, IF they found endo and they removed it, the chances of you getting pregnant goes up by 5% and the endo comes back after one year.  

Another study found that endo has no relevance on IF.  

There are some statics that indicate that something like 40% of women have endo - most of them/us just don't know it.  So, you can also conclude that if endo=IF, there would more far more IF in this world.  

My RE left the decision to me as well and also has indicated that the chances of her finding anything (with me) is very low.

Being that lap is a surgery and based on the two research, I opted not to. Bottom line for me was that having the lap does not guarantee success.

I hope this helps a little.

[JennViv]

Wow, thanks for that information. I feel like, any surgery is SO risky....i'm not obese, but I am a little overweight (could probably lose 30 lbs)...but the RE doesn't seem to think there would be a problem with that. Anyway, the RE pretty much indicated that he thinks even if he found endo it would be SO minimal that it didn't cause the IF. Then i'm worried if they DO go in there and i don't have endo, what if them "poking around" causes scar tissue i didn't have before...is that possible?
Then I look at my aunt who had a normal healthy baby at my age (27)...and years later, now in her 50's, they went in and found endo so bad that they did a hysterectomy (she signed off on this due to her age/not wanting further problems)....HOWEVER she almost died during this operation...her heart stopped & she was "brought back"...another aunt recently died after a knee surgery she had a blood clot when she stood up and died...
I hate to sound selfish but theres so many reasons i am worried about this...

[dnikki0928]

JennViv: I wasn't sure if I was going to comment on this but what I have to say can't hurt :)
I am 22 (almost 23) with PCOS and ENDO. It took several years to get diagnosed with both as all the symptoms I was having and all the docs (usually male) not thinking anything was wrong with me...  The first lap was severe endo, cysts and all the good stuff. I was 18 and had 1/2 of my right ovary removed. It's still functional most of the time.
So far I have had 4 laps done. 3 of the 4 I was at normal weight for my height. The fourth which was done in Jan. I am a little overweight - could lose about 27 to get back to pre preggo size (2years ago!). Anyways, My third lap I had done because I had been ttc to no success. I had that lap done in March of 2006, tried natural that month (nothing) then saw an RE for the first time in the beginning of April 2006. I did no meds (okay, just vitamins and progesterone supp after O) but nothing like clomid etc. He did IUI and I got p/g right away. He was born in Dec. 2006.
We have now been trying again for over a year.... taking clomid, femara with trigger shots etc... I have been pregnant once that ended in an early m/c.  I have done probably a total of 10 IUI's, and somehow we just keep trucking along. This past consult with my RE, he doesn't know why the IUI's aren't working. On paper everything is perfect and I should have gotten pregnant with every IUI. So, here we are. I'm doing no meds this cycle but still going to do an IUI.
Anyways, instead of telling you my whole life story I will get to the point I wanted to make! When I finally got diagnosed with endo that was Severe - and I had many symptoms and huge family history.
There are women I know who have NO SYMPTOMS at all and decided that getting a lap, maybe they could find answers. They had severe endo. They say that 1/2 of women with severe endo won't experience any symptoms because of the location (could be on nerves blocking pain receptors) and the other 1/2 with sever endo will experience symptoms. I can understand your reasons for not wanting a surgery, and the decision is completely up to you.
Whatever you decide I will be here for you :)
If you have any questions or just need to talk, send a message and I will be happy to help in any way possible.

Hugs and Good Luck :)

[JennViv]

Wow...you guys here are all so great...i'm glad i'm hearing alot of different experiences. My biggest fear is that i'm going to have some crazy reaction to the anesthesia and die....Having said that i had surgery about 9 yrs ago with no crazy reactions. So i don't know what the chances are for it going so well again.
dnikki0928 - did you have any different complications since you said your last lap you were a little heavier? Thats my fear since i'm alot heavier than 9 years ago.
This may be TMI but my husband says that maybe i have endo b.c sometimes it is painful during BD & i've read that could be a symptom - don't know how true that is....but it's been that way for years...along with cramps/backaches during AF....SO
I appreciate the support from you ladies while i blabber on and on about this!! =)

[bree08]

Hey I just wanted to ley you know I had my lap done a month ago. I have a few extra pounds on me too. I was scared that it would be more difficult of a surgery because the doctor would have to go through more "layers"! The surgery for me went really good, but recovery didn't go so well. I found out that I'm alergic (allergic) to morphine, so they had give me benadryl and more pain pills. I had too many meds in my body and my oxygen levels went really low. They put a massage thing on my legs to prevent blood clots. They called it my spa treatment for the day! You are so young that you shouldn't have problems espicially if you've had surgery before. I do also want to tell you that I did not have endometreosis, but I did have a fibroid. Before my surgery I had pain during sex. Now, after surgery I have no pain with sex. Good luck to you. I hope everything works out. :)

[brooklyn_gal]

Glad to pass on the info.    One last thing.  I also had 25+ years of severe painful AF ( including backache).  I just finished 3 months of acupuncture and serious herbal medicine - finished in June.  I can honestly tell you that my last AF was not as painful as usual

I am also 20 lbs overweight, but my RE showed no concern for this.  

I myself am going to try one more IVF.  

Good luck!

[Michelleinhawaii]

Hey...I'm going for my first lap tomorrow, I'm very nervous and scared.  My RE said that 1/3 of women who have infertility have endo and some have no signs or symptoms at all.  He also said that if they find endo and clean it out, even if it's only a minor case your chances of conceiving increase by 13%.  They can also check your tubes and uterus at the same time and fix anything that may possibly be wrong.  I trust my RE and if he thinks this will lead to answers and a baby in the end, then I figure it's worth the risk.  This will be my first surgery ever...I have never even had stitches before and I am terrified of needles, blood, and hospitals.  I figure if it doesn't kill me it can only make me stronger. Wish me luck...I'll let you know how it goes.

[butterflybabies]

Hi,
I know its not an easy decision. I have been trying to concieve (conceive) for almost 3yrs now. Finally went to see an RE last Oct. Did an HSG done and found out both my tubes were blocked and I had a polyp. My only options were to do lap to unblock my tubes and remove my polyp or IVF. We decided that since my insurance covered Lap (not IVF) we would start with that. I went in last Nov for my lap. I was super scared and nervous to. I only had one other surgery and that was for my tonsils when I was 13. Im 33 now..Seriously for me the worst part after my lap was the gas that they put in you. It got stuck in my ribs for 4 days..I had to sleep kinda sitting up. It took 2 weeks for the bloating to go down.. and another good thing that happened was my periods were less painful after the lap..( I used to have very painful periods)..If I knew my periods wouldve gotten better from this I wouldve done the lap sooner..Doc was able to unblock one tube but not the other..we tried naturally to get preggers ever since and it hasnt worked. ( I did try Injections and BD once back in Dec, I had a chemical pregnancy) So now we have decided to move onto IVF! Im super excited and scared to!! Good luck to you and I know its not an easy decision but do whats best for you!
SSBD!!