Endometriosis and Fertility: Can You Conceive After Surgery?

Question
My husband and I have been trying to conceive our first baby for 3 years. We're in our early 20's so we figured it would happen quickly. Last year I went to my ob/gyn and he scheduled a laparoscopy because he believed I had endometriosis. I had stage 2 on my uterus with a little connecting to my bladder that wasn't able to be removed. That was almost a year ago and I have yet to conceive naturally. Is my window of opportunity closing from my previous surgery? Is there anything I can do to help move this process along?

Answer
Hello Lindsay from the U.S.,

I hate it when Ob/Gyn docs only do one thing and attribute the infertility problem to that one thing.  Yes, endometriosis could have been the culprit, but there are several tests that should have been done to check your fertility status besides laparoscopy.  If you are in your 20's, you should have gotten pregnant within 1 year, so there is something going on.  You need a complete infertility evaluation!

In addition to the treatment of endometriosis with laparoscopy, we will often follow the surgery up with medication to get rid of any microscopic endometriosis.  Even the microscopic endometriosis can prevent pregnancy.  I then aggressively try to get my patient pregnant within 3-6 months because by 6 months out, endometriosis will often return.  Then you are back to step one again.

At this point I would recommend that you go see an expert in infertility, which is an infertility sub-specialist and NOT a general Ob/Gyn.  If you had done so before, it is highly likely that you would have a baby by now.  When you seek out doctors, many general Ob/Gyn's will say that they do infertility when in fact they do a very limited amount.  Question the office and make sure to find a doctor that does ALL levels of infertility evaluation and care.  It is easy to know because a real infertility sub-specialist will do IVF.  Make sure, however, that if the doctor does IVF, that is not the only treatment they do.  You don't want to go to a clinic that is only going to prescribe IVF and not do the complete evaluation or recommend lesser and less expensive treatments.  We have clinics in our area that are like that.

Good Luck,

Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com

Monterey, California, U.S.A.

for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on twitter with me at @montereybayivf and facebook @montereybayivf