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Surgery v. IVF

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  1. #1
    jsims427
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    Surgery v. IVF

    Just got some upsetting news. After losing twins at 19 wks in April and then an early pregnancy loss/ectopic in July (nothing ever seen on U/S in uterus or in tubes but betas kept rising so RE treated as an ectopic and gave me methotrexate), I have undergone 2 HSGs - the first showing obstruction of the right proximal fallopian tube; the 2nd showing bilateral blockage. How you can go from having just one tube blocked to 2 tubes blocked is beyong me. The next step recommended to me - surgery - lap & hysteroscopy - possible right salpingectomy (RE thinks right tube is destroyed) - cannulation of left tube (to see if it was just a spasm or if there is mucus buildup there that can be opened up). I am so nervous about the prospect of surgery and all of the things that can go wrong - infection, scarring, possibility of ectopic, etc. At first I was tempted to just bypass surgery and go straight to IVF but IVF is not without its own set of risks - not only is it so expensive but I know myself and I would expect it to work on the first try and if it didn't (which I know is a great possibility), I would be crushed. Also, what if I went on to miscarry or lose another baby after spending all of that money? It's just not a guarantee although I know better than anyone that nothing is life ever is.

    The longer I have to go without getting pregnant again is about to kill me. I am 33 and the only one of my friends to not have children, and especially the only one to have such a traumatic loss. But my doctor recommended surgery first.

    As you can see, I have mixed feelings about both surgery and IVF. I would really appreciate any comments and/or advice from anyone who has been there, done that. Thank you so much.
    Last edited by jsims427; 12-28-2009 at 12:31 PM.


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  3. #2
    HolmesHX2
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    I'm sorry not sure what BTDT is but I have PCOS and before moving to injections since pills never worked to get a follicle to grow the doc sent me for a HSG well it shockingly came back with both tubes blocked. I was given 2 options 1 was IVF the other was to try "naturally" in case there was an error in the HSG. I am on injections have been on them for like a month and a half now and still no stinkin follicle to give me an egg but will be trying "naturally" if I ever do get this follicle. Originally I was going to try with hubby for a cycle or 2 before moving onto IVF. I'm in korea right now and the doc here doesnt think the surgery is a good idea to confirm if both tubes are blocked. However I came to the conclusion I'm going to hold off on it all just do injections and BMS with hubby then if nothing works after a few months when I get back to the states I'll find a doctor that will do the surgery and try that way. Personally if they can open the tubes even just for a few short months thats a few tries where as each IVF is just one. Also IVF runs an increased risk of ectopic which just irks the heck out of me to pay all that money because of jacked up tubes to skip the tubes all together and put the eggs in the uterus only to have them go BACK UP the tubes and stick there. Something about them not coming down so you pay thousands of dollars to put them in the right spot for them to go back up lol. Yes I know its surgery and risky but even if there is scaring then whats the worst thing ? have to move on to IVF which would've been the alternative any ways. Sorry for the rant if you cant tell I've been up in the air about it a lot myself just a sucky situation.


  4. #3
    kindhiker
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    jsims427-that is so horrible to have gone through. I see how surgery seems scary and IVF so risky. No one can really say what to do except you and your re. But if it were me and botgh tubes were blocked (which mine are due to previous pelvic surgery), I would want to do surgery and Ivf. IVF isn't a guatrentee, but it usually works by the third time. It's so wrong that we have to consider money when making these kinds of decisions. If they do a lap, they can see what's going on in there. I only speak from my own experience though. I just had a lap after having 2 ivf cycles, neither resulting in bringing home what we are all trying for. I will feel alot better going into IVF again this time because I had the lap. I wish I could fix this for everyone including myself. It's strange how we feel our own feelings and haved our own experiences. But when someone else experiences this stuff, we feel so strongly for them...probably because even though our details are different, we see a bit of ourselves in each other on these boards. My heart goes out to you as you make this decision. If you feel up to it, please let us know what you decide to do.


  5. #4
    jsims427
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    kindhiker - thank you so much for your kind words. You are right - even though all of our situations may not be the exact same, when you struggle through infertility, you connect with others who are struggling as well - you can actually say that you know how they feel. I think you are right about the lap giving me a peek as to what is going on in there. Something is definitely not right and maybe it will be the answer we have been searching for. I just can't imagine what the twin pregnancy/loss did to my tubes but I don't think they have been right since I lost the twins. They were obviously open and clear when I got pregnant with them. For these reasons, I am leaning toward surgery. I am just hoping and praying for a baby to take home from the hospital with me in 2010. Nothing is worse than empty arms and an empty home.

    Good luck to you as well. Am hoping your 3rd time is a charm like I am hoping mine will be. Please keep me posted on you as well.

    One other question - how long after your lap were you told to wait until your next IVF? I'm wondering how long they will make me wait. I hope not long b/c I will be ready to go right after the surgery.


  6. #5
    jsims427
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    Quote Originally Posted by HolmesHX2 View Post
    Personally if they can open the tubes even just for a few short months thats a few tries where as each IVF is just one. Also IVF runs an increased risk of ectopic which just irks the heck out of me to pay all that money because of jacked up tubes to skip the tubes all together and put the eggs in the uterus only to have them go BACK UP the tubes and stick there. Something about them not coming down so you pay thousands of dollars to put them in the right spot for them to go back up lol. Yes I know its surgery and risky but even if there is scaring then whats the worst thing ? have to move on to IVF which would've been the alternative any ways.
    You make such a good point! IVF is the only other alternative I have if my tubes really are destroyed so why not go with surgery first just to make sure. And, IVF is no guarantee, even against an ectopic which is so ironic like you say.

    Wishing you the best of luck and hoping you get some better answers when you get back to the States. I don't blame you for holding off on surgery until that time. My husband and I tried in Oct & Nov (combo of Letrozole & HCG trigger) and when those 2 times didn't work (since I usually respond well with meds & timed intercourse), I knew something was definitely wrong.


  7. #6
    kindhiker
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    I had my lap november 20th and will "allowed" to do a fet in feb/march. I will go ahead as long as I feel good and have no pain. Someone else on ft had sugery around the same time I did and I believe she is either cycling or gearing up for ivf cycle, so it really depends what you and your doctor agree on.


  8. #7
    stephase
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    I was all set to go in for a laproscopy to investigate a possibly blocked tube. The day before we found out my insurance would only pay for a portion of the procedure so we'd have to pay 8,000USD. My RE thoughtfully suggested that that money would be better spent on an IVF.
    She thought that the laproscory procedure and possible removal of cysts may or may NOT help me get preg. So, why not spend that money on a procedure which actually had some odds of getting me preg.?
    This logic help me & DH make the decision although now we have to wait till June/July for IVF (for financial reasons).


  9. #8
    beksma
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    If you don't know why the tubes are blocked, then it would be worth it to have them checked visually. And surgery can work to open things up for a few months before closing up again (or not- each person is different)

    Good luck with whatever you try.


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