Blocked tube + endometriosis: what are my options for pregnancy?

[blue_eyes1]

Hello. I am a 40-y-o woman who was diagnosed about 7 years ago with endometriosis and a blocked tube. I am getting married and would like to attempt pregnancy. My doctor suggested another laparoscopy/hysterosalpingography first to see what's going on. Do you agree?

If I'm still in the same boat internally speaking, what are my options for fertility treatment? It seems that the old-fashioned way isn't doing the trick.

Thank you.

[USF-M.D.-JM]

I would make the case, why do you think anything has changed? Tubes don't open themselves and endometriosis is usually a progressive process. I would check your ovarian reserve/reproducive age/ how many eggs do we think are left? This can be done by seveal blood test that your physician should know. If the lab work says you are on the 41 side of 40, I would counsel you to consider IVF. By the time you do the surgery, allow things to heal, then try for 6 months, here comes another birthday. May sound aggressive but realistic.
Hope this helps,
JM

[blue_eyes1]

I forgot to mention that I have a normal menstrual cycle and I ovulate normally (verified by blood tests and ultrasound).