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@mopeybuthopey: Hi, I'm sorry you are feeling this way. I had a lap to diagnose endometriosis a year ago and the surgery and recovery were a breeze. I had the surgery on a Friday and I was back at work on the Monday.

I would be curious why the RE thinks the radiologist was wrong. Was there not a doctor in the room when you HSG was done to watch the dye "spill" from both tubes?

I don't have any experience with tube issues so hopefully someone else can comment on that. I would want a substantial explanation from the RE before moving to the lap if the condition is likely not treatable, may be better to just proceed to IVF....

I've had to laparoscopies. The first one was done by a much older doctor and recovery was brutal--I was told it should never have been that bad. Apparently i was a wreck inside (i have endometriosis). The second time, it was done by an RE with a laser (faster recovery) and i was feeling great by 3 days later! Huge difference. I've known a few people who got pregnant right after their laps, too. I would only proceed with the lap if it might clear up my tubes--your dr may suspect something else going on in there, and you won't know until you meet with him. It seems pointless to suggest the lap to clear the tubes if it's unlikely to even work.

I'm so sorry to hear the news. Well, my story is very different but similar in that I found out my remaining tube (1st one removed during fibroid surgery in 2010) was blocked during a lap procedure for a cyst after using clomid. The RE broke the news right after the surgery that the remaining tube was filled with fluid and I had no choice but IVF. It's not a hydrosalpinx, though, which gave me a good chance of success and it did work for us. Can you have the RE do another hysteroscopy to check the tubes? I'd want to do that before doing a lap procedure. If both tubes are filled, then you are most likely looking at IVF. I'm so sorry and know how painful this whole process is. Took almost two years for us with multiple surgeries, disappointments, then having to go through IVF. I had depression during those painful years so I know how hard it is and if you want to chat, please contact me!!

My story is long, but it may be just what you are looking for, so bear with me. I promise - there is a happy ending. Also, please, PLEASE feel free to wall me if you have any additional questions or just want someone to chat with/a shoulder to cry on. Your post really resonated with me because it is so similar to what I experienced.

I got my first AF early - at 10. My cycles were always regular, but excruciating. Very heavy flow and horrible cramps. All of the women in my family (mom, sister, grandmother, and my grandmother's sisters) all had the similar issues, so I was told that this was normal. My mom had gone of BCP at 15 to deal with the issues and offered that to me, but for some reason I didn't want to do that (stupid!!!). I started BCP at 18 and, although I still had fairly heavy flow and cramps, my cycles were very normal for what people experience on the pill. I stayed on BCP for 11 years. About 2 years before I went off BCP, I started noticing some weird sensations on the right side of my abdomen in the middle of my cycle. For a couple of days each cycle, I would have dull, shooting pains. They weren't particularly painful, just odd. I chalked it up to ovulation pain and went about my life.

(Note: This was obviously an incredibly stupid assumption, since you don't O on the pill... but it turns out that your body still goes through some of the same motions even though no egg is released - so your ovaries still expand and contract a bit around O just like your ute expands and contracts around AF...)

I went off BCP in April 2011 when my husband and I started to TTC. I am fairly Type A, so I charted (temps, CM, and OPKs) from cycle 1. My cycles immediately returned to the length and regularity that they were pre-BCP, so I was no longer experiencing heavy flow or cramps. My AFs were very light and were preceded by spotting (starting at 12 DPO). I didn't think much of this because I knew BCP could cause my cycles to be wonky for a bit. I assumed (ha ha) that I would get KU right away because both my mother and grandmother had (my mom got KU first try with both my sister and I, and my grandmother had 4 kids in 4 years). I didn't, and the mid-cycle shooting sensation continued.

About 4 months into TTC, the mid-cycle pain started to get worse. It became painful and sharp, and I started having it all day for 3-4 days. I saw my OB to get things checked out and she sent me for some testing - an u/s, CD3 and 21 bloodwork, etc. All my tests were clear, so she sent me to a pelvic pain specialist. The specialist said that my symptoms and family history indicated that I *could* have endometriosis, but that it was far from a clear cut case. She thought it was odd that I was having such light AFs and no cramping, and told me that spotting before AF is NOT normal. Based on all of this, she recommended a laparscopy to see what was what, but I didn't want to do it. I was *sure* that my BFP was just around the corner and I really didn't want to be sidelined from TTC by an invasive surgery.

Meanwhile, my pain was worsening and occurring most days during my cycle. I was in a bad place mentally as well, because my husband I were so ready to have a baby and it just wasn't happening. By cycle 9, I was in so much pain around O that I could not stand up straight. My husband put his foot down and said I had to have the surgery. My doctor said she would do an HSG during the surgery.

I had my lap on a Tuesday. The surgery revealed that I do have endometriosis, but there was not much there. The pathology report revealed that the type of endo I have is genetic and is a "turn and burn" variety that grows very quickly, causing a lot of pain, and then turns to scar tissue. Most of the endo my doctor found was concentrated around my right ovary, which explained my pain. The HSG revealed that BOTH of my tubes were blocked - the left with old endo scar tissue and the right with new endo growth. By exerting quite a bit of pressure with the HSG dye, my doctor was able to flush out my right tube. The left tube was hopeless, I was told.

After the surgery, my doctor gave us 6 months (so, 3 cycles as only one of my tubes worked) to conceive naturally before she strongly recommended that we go to IVF. The timeline was based on her fear that my endo would grow back quickly, re-fill the right tube, and ruin my future fertility. She thought that going to IVF would preserve the chance to conceive a second child naturally. (FWIW, my doctor does NOT recommend removing tubes prior to IVF unless there is a very clear reason to do so - she mentioned several times to me that she thinks it is an irresponsible practice to remove tubes just as SOP for IVF.)

My first cycle after my surgery, I O'ed from the left side. My AF was more normal - no spotting beforehand and heavy enough to make me feel comfortable about my lining. My second cycle, when I O'ed from the right side, I got a BFP. After more a year of TTC, we were successful the first possible cycle. Although I was not ready to have surgery before I did, I kick myself for waiting so long.

My AF returned pretty quickly after my daughter's birth despite exclusively BFing, so I went back on BCP. It only worked for so long to keep my endo pain at bay (I am *much* more sensitive to the pain and my body now), so we decided to TTC #2 a little earlier than originally planned (I am in the TWW of cycle 1 now). The interesting thing is this - I had an HSG at the beginning of this cycle to make sure my right tube is still open. It is, but we discovered that my left tube is also technically open (???). Because I have a lot of scar tissue between my left tube and left ovary (the dye "pooled" considerably there), my doctor is not hopeful about my chances of conceiving on that side, but my point in telling this part of the story is that things can change and shift around with time, childbirth, surgery, etc.

My lap recovery was okay (surgery Tuesday, went to a wedding Saturday night), but it's still major surgery. I waited longer than I should have to have the procedure and I am angry at myself for making that decision. There are, of course, risks to every surgery, especially those that prod at your lady parts... but in hindsight, I would have listened to my doctor earlier. If you don't trust your RE, I would get a second opinion. But if you have been TTC for 9+ months and your doctor recommends a lap, I - personally - would go for it.

ETA: I chose surgery over IVF for two reasons: (1) my surgery was covered under insurance with a $150 copay, and IVF would have cost us $10,000+ out of pocket; and (2) I was not yet at a place where I could wrap my head around so much intervention. If we had not conceived within the 6-month window given to me by my doctor, we would have absolutely gone the IVF route, but I am really glad we didn't have to.

Also, my doctor is a GYN only (not an OB) who specializes in pelvic pain and does a zillion laps a year, so I really trusted her. She is not an RE.

@Happygal: @mopeybuthopey: I have many of the same "symptoms" or lack of symptoms that @Happygal: mentions, I am not a textbook case by any means. The other deciding factor that lead me to go forward with the lap was that I had the CA125 blood test done which showed elevated levels. The test is new and I had to pay for it out of pocket but there have been links drawn between elevated level and endometriosis.

@mopeybuthopey: I hope you don't have to have your tubes removed. We just left mine alone, so I still have it, but it is still filled with fluid. Yep, I'm glad to help by answering your questions. I did IVF at 34 (had my son just after turning 35) and it worked the first and only time. I had to miss work quite a few mornings (came in late by a few hours) but luckily my boss was very understanding and knew all about it. At my RE's office, they would schedule the appt's first thing in the morning, so that way it didn't interfere too much with work days. I also highly suggest acupuncture if you can afford it or are interested in it. Many suggest it helps with embryo implantation. I have no idea if it does work, but I did do it leading up to my IVF cycle and the day before and after embryo transfer and I did get pregnant, so it can't hurt to try! Let me know if you have any other questions.

@mrswin: Interesting about that test! Was your doctor the one who mentioned it, or did you request it on your own? Do you mind sharing how much it cost? (You can wall me if you don't want to discuss cost here.)

@raintreebee: my RE doesn't seem to take a strong stand on things, but I think she would if I pushed her. I think the practice is wanting to match what the patient wants, conservative or aggressive. They also are sensitive to the costs of everything. When I spoke about next treatment steps, I got the feeling he thought moving to IVF was the best choice, but he didn't come right out and say it.

@Happygal: My doctor was the one that brought it up after discussing my family history and symptoms. He said he would prefer to see what the test indicated before recommending a lap. I will have to look at my paperwork once I am home. I had it done over a year ago and I don't remember the cost off the top of my head, I think it was around $150....but I am in Canada so not sure if that will make a difference. I will wall you tonight with the cost

Sorry to hear you have a hydrosalpinx. That stinks and I know you must be so upset, but at least as you said, now you know the problem! Hopefully surgery fixes it so you can get back to ttc again soon!!!