QuestionHi doctor,
I am 27 year old female, married for 1.5 years.
Last year in Nov, 2008 I was operated laparoscopically for endometriomas on right ovary. In the procedure, 1 endometrioma on right ovary was removed and along with that adhesions were also removed. The tubes were made patent.
Now after 6 months of trying naturally I am not able to conceive.
And yesterday I got my HSG done for revaluating the tubes and the reports mentioned that left tube is blocked and the right tube showed limited peritoneal spill even in delayed scans. And suggested right perifimbrial adhesions.
Please suggest what would be the reason that the tubes got blocked even after patenting them.
And suggest what would be the best path to go ahead.
BTW, I am writing in from India.
Regards,
Ria
Answer
Dr. R
Hello Ria from India,
Endometriomas cause a lot of scar tissue formation. For that reason, we consider it stage IV endometriosis or severe endometriosis. First, scar tissue can return despite any preventive measures being done, after surgery. Secondly, endometriosis can return as well and cause additional scar tissue.
With these findings, I would counsel you to go directly to IVF (In Vitro Fertilization) as the treatment of choice. Don't waste your time on more surgery, as the chances of pregnancy would be 1% or less. At your age, you would have a 50-70% chance of pregnany with each IVF cycle.
Sincerely,
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 and twitter with me at @montereybayivf.
