Questionhello..i was diagnosed with bilateral tubal oclusion...did lap surgery a year ago...had 2 miscarriage after that.. did ivf t 2 d5 blast. but none implanted..now my dr. want to do another lap. to see if he can find what went wrong...but i am not sure if that will be the best option for me...or should i go for a tubal canalization? what dr. will be best for this a radiologist or my fertility dr? thank you
AnswerHello Neidy from the U.S.,
It is not necessarily unusual for you to not have had a pregnancy in two IVF attempts, but without reviewing your records I can't comment more specifically. One potential problem is that if a hydrosalpix re-developed (from blockage of the tube), then studies have shown that there is a 50% reduction in IVF pregnancy rates. For this reason, we recommend the removal or separation of the tubes prior to IVF if hydrosalpinges are present. A laparoscopy would be sufficient to find this, and the tubes can be removed/separated at the same time. Or if you prefer that they be opened again, it can be done. My recommendation would be to skip the re-cannalization or repair of the tubes, and have them separated from the uterus so that they don't influence any more IVF cycles. And, I think that IVF is the correct way for you to proceed from there.
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
