Laparoscopy or IVF?

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Hi everyone,

Thank you to anyone who reads and can offer any help or guidance or share their own experiences.

My partner and I have been TTC for a year now (both 32) I’ve always suspected I have endo and after repeatedly telling my GP they finally put me forward to gynaecology and I’m on a 12 month wait list for laparoscopy. I’m also on a separate 14 month wait list for fertility dept. Gyny tell me I need lap first before fertility treatment.

We decided with all the wait lists to go for initial tests at private clinic to rule everything else out. The private clinic found my right ovary is stuck to my uterus and found endo all around my bowels on ultra sound scan. All other things tested for both of us are good. Private consultant said with the sheer amount they found on ultrasound I likely have stage 3 or 4 endo and to go straight for IVF rather than a laparoscopy as there are risks with the lap and it may not improve my fertility, it could have the opposite effect on my fertility. They said I could opt for a Hycosy to see if my tubes are blocked which if they are it’s IVF anyway, and if not could try to conceive naturally but they think my chances are very slim.

Just wondered if anyone has any similar experiences? Fertility consultant says skip laparoscopy and go straight for IVF (and if IVF doesn’t work after 3 rounds then go for laparoscopy) and gynaecology consultant says laparoscopy first….. what do I do??

We tried to conceive for 4 years before I had a laparoscopy. We had also just had our date through for our first meeting at Oxford Fertility Clinic. The lap showed that my tubes were not contracting so was told highly unlikely to become pregnant naturally also had endometriosis. The month after the lap, I fell pregnant. It’s quite common that women can fall pregnant soon after having a lap.

I had a laproscopy due to endo- my consultant knew we were trying for a baby. He advised after laproscopy that I would be extra fertile and 6 weeks after the op I luckily found out I was pregnant. (To add to this I had been using ovulation sticks so knew my cycle, taking vitamins and using conceive plus)

Im no expert but surely the laproscopy “cleans” your uterus etc out so you stand a better chance of conceiving naturally or via IVF?

Hi, sorry to read your troubles conceiving. Having endometriosis also, confirmed bucket shows scarring in tube and cysts on left ovary. I moved straight to big and conceived my 2 children. Personally the lap may work but if you are hoping to have more than one child then ivf may be the quicker option you are likely to have good quality eggs being only 32 and at least one of more normal embryo this fast tracking your family aims. I've heard lap sometimes in the wrong hands can actually reduce fertility more and the benefits of a lap are limited to the first 2 years of you decided you wanted more children down the line it might be repeat laps again. go for big now whilst your young and your eggs are young I was 35 and first cycle I had 2 children. Don't delay go for it. Iv f is time sensitive but a lap if it doesn't work out can come later your still young best wishes to you

I had stage 4 endo (didn't know about it though!) and had it "cleaned up" laparoscopically (in addition to removal of several large fibroids). Probably because of endo one of my tubes is not working but the other is and I fell pregnant 6 months after laparoscopy.

If Hycosy shows you have at least one working tube, I'd probably get the lap first, before IVF as you might fall pregnant naturally afterwards. If not, you'll have the option to go for IVF.

Good luck!

I have endo and PCOS.

Personally I would consider asking if you can be referred to another clinic, a 14 month wait is a huge amount of time and in my experience the clinic put forward options that the GP didn't even discuss or consider.

I had already had a lap about 7 years ago, fertility suggested a new one but were happy to also just do hycosy plus meds (metformin) and then lap and clomid in 6 months if no joy. Endo was treated via diathermy 7 years ago although the jury is out if it made it any better or substantially worse.

We have just conceived on metformin and I am about 4 weeks pregnant, currently in the throws of complete anxiety that nothing goes wrong!! I am wondering if the hycosy had anything to do with it to be honest as we've had no joy, all of a sudden metformin + hycosy and it worked...

One thing to consider is recovery time for the lap, I know that they say it's key hole so shouldn't be long but it took me weeks to fully recover, sex was not on my agenda during that time. That's why this time round, I asked if we could delay the lap and go least invasive to start with. I am 30, for context.

Good luck to you and I hope that it all works out for you xx

Thank you everyone for taking the time to reply and share your experiences, lots of food for thought.

@H212 yes this is my worry, especially when my lap is under gynaecology and their focus is on endo removal rather than preserving fertility. With my right ovary completely adhered to side of uterus I’m worried it could damage it in the process of freeing it up. So happy to hear about your two children and a happy ending to an endo fertility journey.

@Hooverthestairs
Yes that’s a good suggestion, I may do that and see what the private clinic can do in referring me elsewhere. I’m worried with such a long wait list, my endo will just grow and worsen in that time frame.
Good luck with your pregnancy! So happy for you. I’m hoping the HyCosy gives me that miracle BFP after it but I’m not holding my breath.

thank you again to everyone for replying