Q:
“Hi Dr Chen
I have endometriosis and have not been able to conceive with fertility medications and IUI. My doctor recommends IVF but I don’t understand how IVF will be helpful if my tubes are open. Do you recommend IVF in my situation?
Sara”
A:
“Hello Sara! Great question. Many people with endometriosis need IVF to conceive despite open tubes and normal sperm. Even very minimal endometriosis can cause a hostile, inflammatory environment in the pelvis that seems to be improved by IVF- possibly because the hormones create a better environment, including a better endometrial lining for implantation and possibly because growing embryos in the lab helps to insure fertilization and creates a more optimal environment for early embryo development. In addition just because the tubes are open does not mean they function normally. You could have scarring from endometriosis or surgery that impacts tubal function without obstruction. IVF would bypass this issue. We do not fully understand exactly how endometriosis impacts fertility or exactly why IVF works so well, but there are numerous studies demonstrating that IVF is a very effective treatment for people who have infertility and endometriosis, especially if other treatments have not succeeded.
I would recommend considering a consult with a great reproductive endocrinologist at a reputable IVF program. Some helpful resources for finding the right doctor in your area are: Resolve.org, ASRM.org and FertilityAnswers.com. Hope this helps!
