gallbladder removal prior to IVF pregnancy

[31yoFemale]

I'm 31 years old and have a history of yo-yo dieting (my BMI fluctuates between 23 and 26).  Two years ago (when I lived in another city), I had some indigestion that warranted an ultrasound (ultimate diganosis was gastritis).  During the ultrasound, they noticed 3 gallstones in my gallbladder.  I had never had any symptoms of the gallstones.

About 3 months ago, I had some moderate pain in my upper right quadrant.  It was not sensitive to the touch and I would not classify it as intense (I stayed in bed, but I could have walked around as normal if I had wanted).  This lasted on and off for about a week, with each "attack" lasting most of a day.  I didn't see a doctor.  Since then, I've had no pain in that area.

Now I am planning to begin IVF to try to get pregnant.   I mentioned my gallstones and possible week of attacks to my primary doctor, and he spoke to the surgeon, and they insist that I get the gallbladder removed before beginning IVF.

I don't understand this at all.   All my research suggests that prophylactic removal is not warranted.  And my "attacks" were not typical of gallbladder disease at all -- they were moderate, long lasting, and not sensitive to touch, unlike typical attacks, which are supposed to be acute, sensitive, and last 1 to 5 hours.   And even if it was my gallbladder, does a week of a mild attack warrant removal?

I want to do what's right - both for my health and for the health of my future child.  But I don't want to engage in unnecessary surgury. And if I have the removal, how long of a recovery is required before I can begin IVF?

If the NIH etc says surgury is not indicated for asymptomatic gallstones, why is my doc+surgeon recommending it when they haven't even seen the ultrasound and they don't even know if my "attack" was gallbladder.  I feel that they're rushing to surgery, and suddenly all my confidence in my doctor (in general) is gone.   Please give me your take on this whole situation.  1) Should I proceed with surgery?  2) If so, how long before I can begin IVF?

Thank you!

[Kevin Pho, MD]

I would suggest obtaining another opinion.  There is evidence of stones, and "gallbladder attacks" can manifest differently in different people.  Another surgical or GI opinion can be considered  if the treatment option is in doubt.  

Typically, the procedure can be done as a day surgery - sometimes with an overnight stay, with recovery within 1-3 weeks.  

I am not a fertility specialist, so I cannot speculate on when IVF can be started after the surgery.  This should be discussed with your GYN and surgeon.  

These questions can be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
kevinmd_

[31yoFemale]

I thought this *was* the other opinion :)

Simply put ... with known stones, and a past episode that might have been an attack, and might have just been indigestion, is surgery indicated?

[luv_babies]

I had one attack when I was 18 and they took mine out within two months. I would recommend it only because I know people that are pregnant right now and dealing with gallbladder problems and are miserable (I know I would be too). If you feel that uncomfortable about the surgery, definately get a second opinion. I wish you luck.

[JBHK]

Iam a 43 year old female and have been having upper abdominal pain for the last two months. It is usually in my upper rt.quadrant but it does tend to radadiate to my left side. I have also experienced nausea, indigestion upper back pain between my shoulder blades, but mostly on my right side. I also have weird gas pains that come and go on both sides between my ribs. I seen my gi doctor he did an EGD which showed mild gastritis which he thought initially this was the cause. But when the symptons continued and I started having back pain and gas he thought it was my gallbladder. I have had an abdominal ct scan, abdominal ultrasound both were negative. However, he insisted on a Hida scan which showed an e fraction of 32%. He said for me to go on a lowfat diet. My question is Iam still having symptons, probably not as bad, should I consult with a general surgeon. I was told by a friend they will probably not remove my gallbladder with a 32% efraction is this true....

Thanks

Janet