Dealing with PCOS and blocked tubes - IVF or unblock tubes??

[milenaviolet]

Hi all,
My husband and I are TTC this year. I'm 27 and he is 28. We began this journey two and a half years ago only a few months after we got married. Initially I was super excited as no one in my family has a history of infertility so I assumed it would be easy for me. We went to a Dr 6 months after trying and still no BFP.
I am so happy I didn't wait longer to seek help as they took blood tests and ultrasounds and confirmed I have PCOS. Now that I know the symptoms of PCOS I should've seen the warning signs years ago.
My Dr put me on Clomid however I didn't respond. The next cycle we went straight to injectible FSH which I respond to even though it takes a while. In 2012 we went through 4 cycles of assisted ovulation with IUI. All no luck.
Last week I had a laparoscopy, hysteroscopy and dye through my tubes. The good news is that there are no signs of endometriosis. The bad news is that I found out that both my tubes are blocked.
Next week I will know whether it's surgery to unblock the tubes or straight to IVF.
Has anyone been through a similar situation? If they unblock tubes, I'm nervous about an ectopic pregnancy. I'm unsure whether I want to go straight to IVF. Do you think I should do IVF or surgery?
Also is there anyone that has done this and had a success story? I would love to hear it.
Thanks guys

[Phteven]

If you get the surgery and it is successful then you may be able to get pregnant again with minimal assistance.
If you go straight to IVF you will need IVF for the next baby and the one after that. IVF can be very expensive and it can take several cycles to work.

[Mildez]

Definitely straight to IVF and perhaps I'd seek an opinion on removing your tubes or clamping them as sometimes when a pregnancy occurs the liquid inside them can release which is toxic to the fetus and causes m/c. I only have 1 tube left due to ectopic and suspect my 2nd is blocked (I've been having a lot of pain in my tube side and they suspect it might be hydrosalphinx) if this is the case the tube will be removed and we may consider IVF down the track (I've already got children although would like 1 more) Often

[Lenny]

Does having blocked tubes mean you are more susceptible to ectopic pregnancies? Or will unblocking your tubes put you in a position of being normal (or normal with PCOS)?

If there is an option for unblocking your tubes which would mean that you are no more or less likely to have and ectopic pregnancy, then i would chose that option. Do you have a great rapport with your FS? Do you think if s/he said do option A or do B then you will be swayed by their answer? Personally i am incredibly annoyed for you that you wasted so much time and energy and emotion into clomid, FSH etc when, lets face it, with blocked tubes it was never going to work. That's not fair on you!

Is your sole reason for wanting IVF because you are scared of ectopics? DO you have other reasons i.e. sick of waiting, resigned to the fact you'll need it anyway etc? IVF can be a wonderful and fulfilling thing. It also presents problems and scenarios that normal conceptions simple never stumble on.

[Mildez]

From my experience through my work unblocking tubes is not often successful. There is a very high risk of ectopic pregnancy or them blocking quickly again and not getting pregnant at all especially if the dye alone during the laproscopy was not enough to move the blockage along. Did they say why your tubes were blocked? ie from PID or adhesions. Usually unblocking tubes is not recommended. I did alot of research into it and it wasn't recommended by any of the Obs/Gyneas. There are a few Drs who would do it. I found one in Newcastle when I was looking into it but although he did do the surgery the success rate was quite poor. It was mainly for those who were opposed to IVF for religious reasons for example. Unless your able to have it done through a public hospital and go on a waiting list which could be 6plus months at the earliest then recovery time before ttc again IMO for the effort and length of time that will take IVF would be the better option. If you have to pay for it you may even find a stim cycle with IVF is no more expensive then the procedure of unblocking your tubes. By memory I was looking at around $4000 out of pocket. Depending on what IVF clinic you use you may be up for no more then that either. Goodluck with it all and I hope you have the baby you desperately want as soon as possible.

[juniper76]

I think this is something you need to discuss in more detail with your Dr to better understand the pros and cons of each option. My concern with leaving the tubes as is would be a hydrosalpinx (which releases the toxic fluid Mildez mentioned), but clearing them increases the ectopic risk, so there's no simple solution. You need to work out which risk is greatest and which risks can be managed/mitigated. That's the sort of thing that you really need to get advice from your Dr about.

I honestly don't know what I would do in that situation and I don't believe there's one universal "right answer". Consider all the information available to you and do what you think is best for you.

[milenaviolet]

Thank you all so much for your advice. There are a lot of things for me to think about. I have an appointment with my Dr for next Tuesday so I'll just have to wait until I can speak with her. I now have a better idea of what questions I need to ask her so I can make an informed decision. I'll let you all know what she says.