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My RE suspects I have endometriosis, but I did not have a lap so we can't be sure. He says he has found that lap helps endometriosis from a pain perspective and a diagnostic perspective, but doesn't necessarily make you more fertile, so we decided to skip it. (I don't think this is a very common perspective, though there is another HB user whose doctor believes the same thing. I have read a lot of anecdotal evidence that a lap alone can increase fertility though...). Anyway, I'll try to answer any of the questions you had above that I can help out with!

1. I didn't have a lap, but my sister did. The actual healing of the incision wasn't bad (I saw her incisions when she was a week out and they looked great) but she was very uncomfortable for a few days. I think she took a couple days off work and worked from home a day or two.

2. I worked with an RE who "diagnosed" me with endo (again, not a true diagnosis since I didn't do the lap). We were already at 2 years of TTC so we had moved beyond anything my regular OB would do (he stops at Clomid). Personally, one of my biggest regrets of our whole TTC journey was not going to an RE sooner, so I highly recommend it.

3. I had an HSG and everything was clear. HSG and lap are very different, so I don't think they would accomplish the same thing. HSG pushes dye through your uterus and tubes, while a lap generally removes the tissue that is growing outside of your uterus. I guess endo does affect some people's tubes, but I think the tissue would not be easily cleared by pushing dye through the tubes. That's my understanding of the two procedures at least.

4. I charted early on in my TTC journey but had given it up long before my endo diagnosis. My RE is not a big advocate of charting during IVF so I never picked it up once we were moving forward.

5. Yes, I have a strong family history of endometriosis. My older sister had a lap and found pretty advanced endo. Two of my aunts had endo so bad that they both had hysterectomies before they were 40. I strongly suspect my younger sister has it as well, and possibly my mom (although she never had a problem conceiving, she has a lot of the other symptoms of endo).

I hope some of this helps. If you have more questions, please let me know!

@septca: Interesting - I didn't know that endometriosis causes blocked tubes that often! I guess since my HSG was completed before I started seeing my RE and everything was clear, we didn't go into that in depth. My RE had a different explanation for why endometriosis causes infertility, but I think some of his theories are a little off the beaten track because I often find different things when I google. Oh well, IVF worked for us so I guess it doesn't matter too much if his ideas on some things are different!

@Cole: I realized I didn't answer all your questions. Again, I haven't been officially diagnosed b/c I haven't had the surgery, but I'm happy to share what I've discussed with my RE.

1. "I am a nanny so I feel badly taking off but it also seems like lifting and dealing with tantrums or what have you might be really hard even a few days out."

Yes, based on what my RE says, you'll need to take time off not to be lifting things. You might be just fine in a day or so, but you should plan for not doing that kind of lifting for 5.

2. "Did you see your gynecologist or a re? Do you recommend one over the other?"

I would recommend going to the RE for many reasons: my RE does multiple lap surgeries a week and is up to date on the all the endo info, they are accommodating with scheduling, and they can look for other things that might be going on as well. I think it's important to be closely monitored on meds, and it doesn't seem like most OBs do this.

3. "Did you have an hsg? In my mind an hsg and maybe clomid or femara right after would be a good alternative to a lap?"

I did have an hsg and it was clear. Here's something that I just learned from my RE: endo can cause problems b/c of blockages. But it causes inflammation, and that inflammation is harmful to both egg and sperm, so it's not just a "let's clear things out" type of issue. Endo can also be causing an adhesion in an area that a HSG wouldn't clear out anyway.

4. "Did/Do you chart? I found an abstract yesterday saying that but in women with endo stays high during menses which is true for me. Did you notice this? Did you spot before your period or have a short luteal phase?"

I did chart, and my temp drops. My luteal phase is normally fine, although I have had a few that were 11 or less. I sometimes spot before, but not always.

5. "Did you have a family history? My grandmother had endo and one aunt has unexplained infertility and never had a live birth."

Yes, my mom and both her sisters had a lot of endo, and that's just the women I know of for sure. My RE said that based on family history alone, I have about a 60% chance of having it myself.

I know it feels like a big decision as it's one I may be facing myself. Have you had any other testing done? If not, I would start with the usual fertility testing: hsg, bloodwork, SA, before looking at a lap.

Did you see your gynecologist or a re? Do you recommend one over the other? I saw an RE. My gyno never caught my endo symptoms, but my RE saw a stuck ovary on the ultrasound that led to my diagnosis.

Did you have an hsg? In my mind an hsg and maybe clomid or femara right after would be a good alternative to a lap? I had an hsg and my tubes were clear. The infertility mechanism for endo is really complicated though--some thing that it creates a hostile environment for the embryo even if everything is okay structurally.

Did/Do you chart? I found an abstract yesterday saying that but in women with endo stays high during menses which is true for me. Did you notice this? Did you spot before your period or have a short luteal phase? Yes, my temp stayed high during menses (interesting I've never head that before)> Yes, I spotted. My LP was around 12 days.

Did you have a family history? My mother once told me she had it, but now she claims she never did!

Anything I can pay attention to or notes I can make over the next few weeks that might help my doctor? I would read up about IVF v. laps. My RE was of the opinion that laps were kind of old school for endo since they rarely increase fertility, do not help the success rates for IVF, and have risks (like damage to ovaries). He felt that they were best used for pain relief. I read several studies, which seemed to comport with what he said. Of course, it's a tough decision when insurance pays for a lap but not IVF!