QuestionI am 33 years old and have been diagnosed with stage 4 endometriosis by laparoscopy to remove it.My husband and I have been trying to get pregnant for almost 3 years with no success despite having the laparoscopy done 4 mths ago.Is IVF my only option or are there other fertility treatments? I have open fallopian tubes,should IUI be considered an option and fertility drugs?And if so how successful is it,considering me being at stage 4 in endometriosis.
AnswerHello Mandy,
With stage IV endometriosis, I usually will recommend IVF. That does not mean that it is the only option for treatment, certainly IUI can be used, but it has the highest chances of success.
Pregnancies have certainly occurred with natural cycles after surgery or IUI but they are small (low chance approx 1%). There is no cure for endometriosis and although your doctor may have removed as much as feasible, some will remain and the pelvis will continue to be hostile to the egg (think of the pelvis as the bowl that the egg flows into at the time of ovulation. It then needs to get to one or the other tube, but with endometriosis it is as if that bowl were filled with boiling water from the inflammation which kills the egg). Because the pelvis is a hostile place, the only and best treatment is to prevent the eggs from exposure to this area, and IVF is the only way to do 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
