LAP surgery
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Thread: LAP surgery

  1. #1
    Supporter megeyre's Avatar
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    Default LAP surgery

    Hi ladies. Your advice on here is always so valuable so here I am again with a question. I have been meaning to post this for a while but have been so busy lately- how is it already January 2012?!

    Anyway- had a consult with our RE for the next steps. We tried 4 cycles of Femara/Novarel (trigger) and timed intercourse all resulting in BFN. (We did 6 cycles on clomid before this with our OBGYN) RE suggested we move to IUI with injectibles but we have opted to try one or two cycles with Femara and IUI. As many of you know- it is a big step up in cost to move to the injectibles and we just want to see if adding in the IUI will help.

    Sooooo now to my question. IF the Femara/IUI cycles don't work we will move to injectibles- which is RE's advice. He says textbook move would be to do a LAP surgery first to rule out anything that may be preventing implantation BUT since I have not signs/symptoms of anything wrong in there- he suggests we avoid sugary and try a few cycles of injectibles first. If we have no success, then have the LAP because typically if everything in there is healthily he excepts the injectible cycles to work. Insurance would cover the LAP but they don't cover any of the meds. I'm a little nervous we will spend a bunch of money on the injects- they won't work- and then I will have to have the LAP anyway. There are just so many unknowns and it's killing me.

    So I guess my question is- would you LAP now or later?
    ~Meg, 27

    DH Andrew, 31
    6/16/07

    TTC #1 since April 2010
    Unexplained IF
    3 IUIs = BFNs
    9/12 IVF #1= BFN
    12/12 IVF #2= BFN

  2. #2
    Mega Poster celticbandgeek's Avatar
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    Hi Meg!

    I'm sorry this has been such a long, frustrating road for you, and I'm glad you've got a plan for going forward with adding the IUI to your current drugs. I know exactly what you mean about the $ jump with the injectables...it was quite a case of sticker shock for us. Thankfully, my insurance covers a pretty good percentage for us. Not all of it, but enough to take some of the sting out of it.

    I don't have a lot of specific advice for you, I'm afraid. I have not had a LAP, and am not planning to have one. My RE and I discussed whether it would tell her anything that would make a big difference, and we decided that it wasn't worth it for me. I guess my question for the Dr would be, what exactly does s/he think a LAP would find that would not show up on an HSG, saline-sono, or hysteroscopy with biopsy? What exactly could then be done about whatever was found? If the answer seems like something that you would follow through with and is likely to be effective, then I'd say to do it sooner rather than later. For me, it would have to be something pretty convincing...in the interests of giving you my full mindset on it, I've never been a fan of doing any kind of invasive surgical procedure "Just to see." But that's a personal decision, and you have to do what you feel you need to and what you are comfortable with.
    Jean


    2011/2012 - 1 M/C, 5 CPs

    JLIH from here on out and leaving it in God's hands


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  3. #3
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    Hi Meg,
    Sorry for your struggles. Sounds like you've been through a lot already. Do you have an diagnosis that explains your infertility? have you had an HSG? I think I have a little different perspective based on my experience. It seems like a main reason for a laparoscopy is to check for endometriosis, although there are probably others. Some people don't have symptoms of endo, but it is a main cause of infertility.

    I think everyone is different, but for me personally, in your position of having tried almost a year of medications, I would do a laparoscopy sooner rather than later. I understand and respect Jean's point of not doing surgery possibly needlessly, but when I was in the position of choosing fertility treatment or surgery, I had the opinion of not wanting to load my body with drugs without knowing we'd tried everything to find out, and fix, what the problem was. (However, in my case, my doctor highly suspected endo, and my sister had it, making my decision easier.)

    It is covered by your insurance, and speaking from experience, it is not that bad of a recovery, and I had all kinds of stuff done during mine! If it shows nothing, then you go on with the original treatment plan. If it uncovers something, then you haven't spent money, and time doing something that may not have worked anyway. The tricky thing for you is that your doctor must not suspect endo, otherwise he would probably be pushing for a lap.

    My sister tried naturally for 6 months, then started on fertility drugs/timed intercourse (Femara, I think). Did that for 6 months, then had a laparoscopy that uncovered endometriosis. Her HSG showed no problems, the usual bloodwork was normal, but she wasn't getting pregnant. The "unexplained" diagnosis, became "explained" after the laparoscopy. Not only that, but she got pg the first cycle after the lap, without drugs at all. Didn't work like that for me, unfortunately, but my endo is worse.

    Anyway, wanted to share my perspective. It is a totally personal decision, and I wish you the best of luck. Keep us posted on what you decide!
    ~Kara~

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  4. #4
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    Hi Meg,
    Sorry for your struggles. Sounds like you've been through a lot already. Do you have an diagnosis that explains your infertility? have you had an HSG? I think I have a little different perspective based on my experience. It seems like a main reason for a laparoscopy is to check for endometriosis, although there are probably others. Some people don't have symptoms of endo, but it is a main cause of infertility.

    I think everyone is different, but for me personally, in your position of having tried almost a year of medications, I would do a laparoscopy sooner rather than later. I understand and respect Jean's point of not doing surgery possibly needlessly, but when I was in the position of choosing fertility treatment or surgery, I had the opinion of not wanting to load my body with drugs without knowing we'd tried everything to find out, and fix, what the problem was. (However, in my case, my doctor highly suspected endo, and my sister had it, making my decision easier.)

    It is covered by your insurance, and speaking from experience, it is not that bad of a recovery, and I had all kinds of stuff done during mine! If it shows nothing, then you go on with the original treatment plan. If it uncovers something, then you haven't spent money, and time doing something that may not have worked anyway. The tricky thing for you is that your doctor must not suspect endo, otherwise he would probably be pushing for a lap.

    My sister tried naturally for 6 months, then started on fertility drugs/timed intercourse (Femara, I think). Did that for 6 months, then had a laparoscopy that uncovered endometriosis. Her HSG showed no problems, the usual bloodwork was normal, but she wasn't getting pregnant. The "unexplained" diagnosis, became "explained" after the laparoscopy. Not only that, but she got pg the first cycle after the lap, without drugs at all. Didn't work like that for me, unfortunately, but my endo is worse.

    Anyway, wanted to share my perspective. It is a totally personal decision, and I wish you the best of luck. Keep us posted on what you decide!
    ~Kara~

    Lilypie Pregnancy tickers

  5. #5
    Supporter megeyre's Avatar
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    Jean- Those are good questions to ask my RE and I know he doesn't have reason to think anything will show up on the LAP, besides the fact we have been TTC for almost 2 years with no success. The thought of this surgery definitely is intimidating.

    Kara- Right now I have unexplained infertility. I have had an HSG that was clear and normal. All of the bloodwork, hormone levels, etc. are all normal. DH's count and morphology are great. So I guess this is why RE is leaning towards waiting on the LAP. But I have heard stories like your sister's where everything was coming back normal until the LAP and finally the reason for IF is explained. AHhhhh decisions decisions

    Thanks so much for your perspective- it really does help to read about other's stories and experiences.
    ~Meg, 27

    DH Andrew, 31
    6/16/07

    TTC #1 since April 2010
    Unexplained IF
    3 IUIs = BFNs
    9/12 IVF #1= BFN
    12/12 IVF #2= BFN

  6. #6
    Super Poster E-Koz's Avatar
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    I'm a little late to this thread, but I thought I would throw my 2 cents in for what they are worth. My DH and I had been trying for one year with no success. At 6 months (because of my age) my RE ran all the usual tests and they came back great, including my HSG. So, I was kind of in that unexplained infertility bubble too. At one year we started considering IUI/Injectables too, but my RE thought the lap was important to rule out anything before going down that road, since we are OOP on fertility treatments, and yes, the lap was covered by insurance. I had it done January 6th and am VERY glad I did as they discovered stage III endometriosis, which my RE says without questions is the cause of the issues. I had NO symptoms at all, and had they not done the lap it would not have been discovered. If I had done the IUI/Injects without the diagnosis I would have been going in totally blind, and honestly, with endo (depending on the stage) it isn't allllll that successful. I know the idea of voluntary surgery is no picnic. I was really scared. But if you're seeking my opinion, it's worth it to rule in/out what might be going on.

    As far as the procedure itself--really not all that bad. I felt REALLY swollen for 3-4 days and the day after the surgery when the CO2 gas is trying to leave your body I had a lot of aches and pains in my back and shoulders (fairly typical). But within one week I was "back to normal" and have resumed going to the gym, etc. I only took 2 days off work. And you can't even see the incision.

    Hope that helps because it's a tough decision to make!
    --Erin

    Age: 35
    TTC #1 since 2/2011
    August 2011: After 6 months of trying, all tests including HSG come back great.
    January 2012: Diagnosed with Stage III endometriosis--cleared during surgery
    March 14, 2012: Clomid/IUI #1--BFN
    April 2012: Clomid/IUI #2 --BFN
    June 27, 2012: Start IVF cycle




  7. #7
    Prolific Poster 1aBABY's Avatar
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    I'm late too...sorry! While TTC#1 I was also diagnosed with unexplained infertility. I had all of the tests and all came back normal. My doc suggested the lap and honestly at that point I wanted a baby so bad that I would have done anything. I'm glad I did! He found endo and a bleeding cyst on one of my ovaries. None of that would have been dedected without the lap. Only 2 cycles later I was pregnant.

    Fast forward 4 years and I'm currently TTC#2 and again without any luck. I just had another lap done Dec. 5 and they found that one of my tubes was behind something...being crushed so to speak, therefore it was not functioning. He moved it, cleared out both tubes, removed some scar tissue and adhesions (endo). I sure am hoping this does the trick! I'm currently on my second cycle after the surgery and I'm not hopeful as I don't have any symptoms and of course I've been testing like every other day. LOL

    Being put into that "unexplained" catagory really sucks! I hate it. It makes me sad and mad that some of us have such difficulties.

    Good luck with what ever decision you make.
    Last edited by 1aBABY; 01-18-2012 at 11:06 AM. Reason: I really should proof read!
    ~Dawn~
    DH: Greg, highschool sweethearts married 9.25.04
    DS: Josh, 10.22.08


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