Understanding Your OBGYN's Recommendation for Endometriosis

Question
Dear Dr. Rappaport
My husband and I have been trying to get pregnant for the last year.  I am 34 years old and never had children.  I have not been on the pill for the last seven years. My husband used the pull out method so we would not fall pregnant the previous six years. The advise my OBGYN has given me is to have the Laporoscopeny (s.p.?) in January because she suspects endometriosis.  I agree totally to this procedure because she said that the six months after the surgery is the best chance to fall pregnant.  The thing that confusses me the most is that she wants me to take the pill for two months before the surgery and stop the day of the surgery because her rational is that the body has a surge of hormones.  This terrifies me that this may be a mistake and does not make any sense to me.  My OBGYN is also my boss. She is known to be a great OBGYN but I have never heard of taking the pill to uped your chances of falling pregnat.
Regards Rochelle

Answer
If you have been trying to conceive for a year, it is definitely time to start an infertility workup. A workup involves preparing a Basal Body Temperature chart to see if you are ovulating, an endometrial biopsy to see what is going on with your endometrium, a hysterosalpingogram to assess the patency of your fallopian tubes, and a laparoscopy to see if there are any tumors or endometriosis. I have never heard of anyone suggesting that you tak birth control pills for two months prior to the surgery. Endometriosis is merely the presence of endometrial tissue in places other than the inner uterine wall. If you have endometriosis, at laparoscopy the surgeon will try to cauterize the endometrial implants. I do not agree with the rationale. However, if yoo trust your doctor, I guess you should follow her recommendations. You can always consult another gyn for a second opinion. YOur doctor will not mind at all.