Hi Doctor,
I am almost 40 years old and I am planning on having a laparoscopy (lap) followed by IVF to take care of my moderate to severe endo. Initially, I was considering pre-treating my endo with BCP & femara (2 cycles) and then lead into IVF but I wonder if surgery will give me a better chance of successfully conceiving with IVF?
My questions are:
1. In your opinion, is there an advantage of one option over the other: (A). Lap + IVF or (B). BCP & Femara + IVF?
2. I believe that the lap + IVF option will help with the inflammation but I am not sure if it will help with the lack of beta 3 intergin. Are you aware if the laparoscopy alone will take care of both the inflammation and missing beta 3 intergin?
3. There is evidence that BCP & Femara/letrozole can help if the beta 3 intergin is missing. After a lap is BCP & Letrozole something that should be considered? I want to increase my chances of success as much as possible.
Thank you doctor. I look forward to your reply. By the way, I love your forum!
Lolo
Lap before IVF
Re: Lap before IVF
Hi:
1. I do not believe that there is clear evidence that one is better than the other. Recent data we have seen from Europe shows that 6-8 weeks of BCPs and Femara restores endometriosis patients to the same success rates as average with IVF.
2. Any treatment of endometriosis, medical or surgical, may help restore beta-Integrin if it is absent, but it also may not.
3. If you have had a biopsy showing no beta-Integrin activity you may want to consider both. Lack of expression of beta-Integrin is not that common and is usually tested for only after unexplained IVF failure with good embryos. If you have not had a biopsy you may want to select one method of pre-treatment.
Different doctors will have varying opinions on this topic as the best course for an individual may not be entirely clear.
Good luck.
Arthur L. Wisot, M. D.
Reproductive Partners Medical Group, Inc.
Redondo Beach, California
1. I do not believe that there is clear evidence that one is better than the other. Recent data we have seen from Europe shows that 6-8 weeks of BCPs and Femara restores endometriosis patients to the same success rates as average with IVF.
2. Any treatment of endometriosis, medical or surgical, may help restore beta-Integrin if it is absent, but it also may not.
3. If you have had a biopsy showing no beta-Integrin activity you may want to consider both. Lack of expression of beta-Integrin is not that common and is usually tested for only after unexplained IVF failure with good embryos. If you have not had a biopsy you may want to select one method of pre-treatment.
Different doctors will have varying opinions on this topic as the best course for an individual may not be entirely clear.
Good luck.
Arthur L. Wisot, M. D.
Reproductive Partners Medical Group, Inc.
Redondo Beach, California