Laproscopy or go straight to injectables??

[sherick]

Hi Ladies,

I just back back from my RE appt. I went in thinking we were switching from Clomid to injectables and I came out with no meds and a lap scheduled for next week! Now I'm wondering if I made the right decision to go with the lap.

Here's my history: I'm 37, one 2yo child conceived without help, TTC#2 on own for 7 months. Did 3 cycles of Clomid with 2 IUI's. I have no ovulation probs, with or without Clomid. HSG was clear. I have no symptoms for Endo and my RE said she doesn't have any reason to believe she'll find anything in the lap. She said that you should take a month break between Clomid and injectables to let the ovaries rest. Since we're not doing any tx this month, we should take the opportunity to do the lap to rule out any probs so this isn't a "wasted" month.

Has anyone else faced this dilemma?? I really want to go straight to the injectables and skip surgery, but obviously I want to do what will get me pg the soonest!!

Any advice would be greatly appreciated

Sherick

[allib]

Hello! I am in a similar situation. We get one more IUI then we are at a crossroads. Our doctor said that she would normally do a lap but she doesnt think she will find anything. Since we have one more IUI, we didnt go into more discussion.
If you dont want surgery, then dont do it. I am a big believer in sticking with your gut feeling. Could you talk with your doctor about what she said previously about probably not finding anything? Bottom line: it is your decision!
Good luck to you!

[sherick]

Hi Allib,

Thanks for responding. I'm leaning towards skipping the lap. I can always do it later down the road if I'm still not getting pg. I'll probably only do 2 more iui's anyway and then go to ifv where tubal probs won't be an issue.

Did your RE mention anything about taking a break between clomid and injectables to rest your ovaries? Just curious.

Good luck with your iui

[BC-Shelli]

Just another point of view....

Endo can be symptomless for many women. Both my doctor and I went into my first lap thinking we would find nothing. We did it because I had unexplained IF. Both my doctor and I were shocked to find endo.

And if you think IVF will bypass endo, think again. Research has shown that endo on the ovaries can effect egg quality and endo anywhere in the pelvis can affect implantation in some women. If it's there you want to treat it.

[allib]

Well we havent discussed injectables yet. I am seeing an OBGYN for now, although we will be switching to an RE in the coming months if the OBGYN doesnt succeed. She wants us use clomid one more cycle then take a month off to allow the lining to heal. This will be our third cycle with 50mg of clomid and on ultrasound I produce 2 follicles with that.

BC-Shelli makes a good point about the endometriosis, that is something to bring up with the doctor!

Good luck with your journey, wishing you all the luck!!!

[sherick]

BC-Shelli - thanks for your input. I didn't know endo could affect egg quality. It's so scary to think of all these symptomless things that could be going on in there!

Allib - good luck with your last round of clomid. I hope you never reach the crossroads of tx

I've been thinking about what I'm going to do and finally came to a decision. I'm going to put the lap off until november because I'll probably have to sit that cycle out anyway (we'll be out of town for a week and my dh out of town for almost two weeks). I can't imagine my cycle cooperating with all the travel plans! So I'll just try 2 rounds of injectables with no break and then take a rest and a lap in Nov. And then on to IVF after that. Uughh .... ttc is so emotionally exhausting.

I wish you both best of luck!!

[fetch]

Sherick, your story sounds like mine.

I conceived my first via IUI on the first try (male factor).

Since June 2007 we've done 7 IUI cycles.
I did one natural cycle, 4 clomid cycles and 2 injectible cycles (Follistim).

I had an HSG before starting the two injectible cycles -- which showed my tubes were open, so no concerns not to proceed.

After two awesome injectible cycles failed I decided to take a break, then booked a diagnostic lap, hysteroscopy and D&C, (late May 2008).

To both the surprise of my RE and myself, I was full of severe, thick adhesions to my ovaries, tubes, uterus and bowel.
My ovaries were twisted, but stuck to the side of my ovaries, making it impossible for the sperm and egg to reach each other, however, my tubes were still open. IVF wouldn't have worked according to my RE either because my ovaries were unreachable. My bowel was stuck to the back of my uterus.

That surgery was the best thing I ever did. I kept wondering what i was getting into because there was no reason to think I'd have adhesions. I didn't even know what they were before this.

Last week I had the second lap surgery to remove the tissue.
I say the lap is your best bet. Hopefully they won't find anything, but hopefully they do find an answer... that can sometimes be the hardest part, not knowing why.

[sherick]

Fetch, thanks for sharing your story!! I'm so sorry you had to go thru so many unsuccessful iui's. I've only been thru 2 and it's been SO emotionally draining. I'm so glad you had the lap and were able to figure out the problem and fix it. OMG, that's so scary that all the stuff was going on inside of you and you had no symptoms!!! And you're so right, not knowing is the hardest part.

I'm going to give it 2 more cycles (with injectables) and then go for the lap in November, since I have to take that month off anyway. Did you take a month off between clomid and injectables?

Thanks again

[fetch]

I did take 1 cycle off after Clomid because it fell around Christmas time for me, so I mentally needed the break. After the holidays is when I did the HSG and following that is when I did Follistim.

I had a lot more success on Follistim, so much so that I got OHSS the two times from a very low dose, (one time worse than the other). Clomid worked okay for me too, but for me, I wouldn't hesitate to do injectibles again. Although so darn pricey, saves so much time and I developed many more mature follicles.