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  • Q&A with Australian Health Practitioners

    Does my endometriosis diagnosis mean I need to go on IVF to conceive?

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    Endometriosis Pelvic Pain Women's Health
    Hi, I am 29 years old and have just been diagnosed with endometriosis. I have been trying to have a baby for 2 years now, does this diagnosis mean I need to go on IVF to conceive?
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    Thanks

    Dr Joseph Jabbour

    Gynaecologist, Gynaecologist - Infertility (IVF) Specialist, Obstetrician

    Dr Joseph Jabbour is a specialist Obstetrician & Gynaecologist and Fertility Specialist with Monash IVF situated in Sunnybank (Brisbane Southside). Dr Jabbour has had the … View Profile

    Hi,

    Having endometriosis does not necessarily mean you need to have IVF to conceive. I have managed quite a few patients with excision of moderate to severe endometriosis and they have spontaneously fallen pregnant shortly afterwards. This would be dependent on the exclusion of other possible causes of infertility.

    Having unsuccessfully tried to fall pregnant for 2 years requires a thorough investigation for a cause of this infertility. You would need to exclude issues with ovulation, problems with your tubes, and abnormalities with your partner's semen. A test for ovarian reserve such as AntiMullerian Hormone is useful. If these investigations are normal and the only cause found is endometriosis, the optimal time to achieve a pregnancy is the first 6 months after laparoscopic treatment of the endometriosis. Seeing as you are <35 years of age, timed intercourse with an attempt at natural conception is an option especially if the endometriosis is not severe. You can time intercourse with the help of Over The Counter urinary kits that measure LH. If the endometriosis is severe, an option for you can be ovulation induction with Intrauterine Insemination (IUI). Ovulation induction can be with clomiphene, letrozole, or FSH injections and once ovulation occurs IUI can be performed. IUI ensures the semen is of high quality and concentration and is injected directly into the uterine cavity through the cervix. If this fails after a few attempts, IVF would be the best option. Obviously for a patient is > 35 years of age, a more rapid approach would be warranted and if IUI fails after 2 attempts, IVF would be the best option (IVF can be the first option also). 

    Good luck.

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