To Lap or Not to Lap after failed IVF?

Hi Everyone,

Really hopeful someone can offer their opinions on having a laproscopy or not asap:)..thanks in advance!

I've done 4 ivf cycles - all BFN. I have had a HSG (dye Test for tubal blockages) all ok, an ultrasound and most importantly a recent Endometrial Biopsy where they did a D & C. I was advised I have no endometriosis to be seen and don't need a lap as the Uterine cavity & lining is normal. I had a second opinion who advises a laproscopy..Do I really need this since there is no endometrius present and IVF bypasses the tubes??..I don't see what the purpose is for (I quiver at surgery) except that it will tell me any reason why I haven't conceived naturally ).

What else is the purpose of lap if I'm alreadying doing IVF with those procedures already done?..If anything what's the RISK of not having a lap.

Anyhelp would be sooooo appreciated. Thankyou:)

Hi Charleotte

Welcome to BB !

I have just had my 5th cycle fail, at age 41. FS and I decided to have a LAP, in fact, it is on Monday the 5th. He basically told me that they will check for Endo, flush my tubes, and I will have a dnc.

A g/f of mines FS told her every woman has a small amount of endo by our "age", and he cleared that for her.

What was your second opinion FS's reason for the Lap ? In my limited experience of End Bio, you seem to have checked out A OK ..

Hi Loveabub,

Goodluck with your lap & procedures on Monday:hello:. they say its a good chance after a D&C that the emby can stick so fingers crossed for you. D&C was a painless procedure .

The other FS didn't say the reason for me to have a lap only that after 4 failed cycles that I should. I'm so confused!!!..other clinics will tell you it takes an average of 4-7 ivf cycles to succeed in a BFP. Is it really necessary....Yes I do think it would be good to see if anythings going on in me that may be preventing me getting pregnant but we have only been trying for just under 1 year & went straight to ivf - you know ..that damn age factor lol!

What else can a lap find that could hinder ivf?

some FS's won't start IVF without doing a lap, as they just want to be sure everything is OK. I was very sceptical about this and my sister went to a FS that wanted her to do a lap prior to IVF (and they were only doing IVF 'cos her DH had a vasectomy) so there was nothing to say there was any thing wrong with her. Anyway they found she had polycystic ovaries which altered the way her treated her. so it was worth it. Now I sort of think a lap, should be done after a few failed cycles, even if just for peace of mind that there is nothing they don't know about. and after a few EPUs a lap is really not much worse.
good luck

Hi charleotte..

Just to add my two cents worth.. My FS requested a Lap before I started IVF as he believes that the health of the uterus and surrounding organs are very important to achieving a PG... When I had my Lap I wasn't surprised to find I had scarring in my tubes but was astounded to find I had a little Endo and one of my ovaries had adhered to my abdomen wall because of the Endo... For me I was happy to have my FS know what he was dealing with... Good luck with whatever you choose... I hope you get your PG very soon...

Charleotte, Hun to be honest I am really nervous about the Lap, Dh does not want me to have it, but what can I do ? I need to be sure that I have given ttc the best shot, I have left no stone unturned.

As for the number of cycle's to a pregnancy, your right, I sat in my FS office the other day, and said "I have had 100 eggs retrieved, and no BFP, and he said NO, you have had 10 embryo's transfered, you need to keep going, you need to transfer at least 8 times before you, as I put it, throw myself on the ground, in complete despair ! That is the hardest thing with all this, keeping the faith and the strength to keep cycling.

I am nervous too about the surgery, but after all we have been through, what's a Lap in the scheme of things ! (no jinxing here please universe) I trust my FS, and if he thought this Lap was a Big Fat Waste of Time, he would tell me, trust me. He isnt in his office to moddy coddle me, he is there to get my a bfp

Hi Charlotte & welcome to BB :D

In my opinion (coming from a veteran TTCer & IVFer) - the lap can't hurt ;)

There are most definately things that they can find.. and a lot of the time fix while they are in there that may not come up from a D&C or HSG.

Perhaps the other things to ask about is having your immunity checked (especially for NK cells) - this can be a matter of a different protocol for your cycle... and also changing things up a little for your next cycle eg. do you always have your embryos transferred at the same time? (day 3 or blastocyst) Do you always use ICSI or do they fertilise on their own? Do you always use the same progesterone support? Have you tried different cycles (eg. slow down reg or antagonist)... there's a stack of things to consider, and one tiny thing may be the change that makes the difference ;)

I personally think the lap is a good idea.... and recovery is great, you'll be feeling perfect in a few days after :D

Hoping I haven't thrown too many things at you & made you think you have all sorts of problems (none of these are problems, just different ways to approach a cycle ;))

Best of luck hun & look forward to seeing you around BB :hug:

thanks so much girls...your'e sooo full of great advice!..what would we do without this forum!!!..bother DH too much with the 'What if's'

Just quickly great to hear all different responses and have decided YES i will get it done...gosh its good to know if there is any reason why I've never fallen preggie naturally...

Just quickly HOllybolly - think I've spoken to you before or maybe it was HollyMolly?..someone doing intrilipids at monash for nk cells...anyway yes FS wants to check the NK levels whilst doing the lap so that will be good, and I'm doing the long down reg on the pill thing...that's a long one compared to flare...her'es hoping.

Finally worked out you have to arm yourself with heaps of knowledge so you can discuss options with FS..taking charge!
Thanks girls...
Loveto be mum - goodluck with lap!..please write back how it went..
hugs and good babydust to all us stars.

Holly and Charlotte

You girls are genious's !

I just rang my FS and asked to be tested for the NK cells, while I have the Lap on Monday, it would never have occured to me .. :rolleyes:

:)Great LoveaBub! - yes they need to do a Uterine Biopsy to check the NK Cell levels. Aparently though it has to be done 1 week prior to AF- that's when they're most active so check where you are on your cycle. ..so around Day 21-23 etc..that's where my lap/NK Biopsy is booked..Oh and a blood test too. Problem is though there must be a preggie test the day before I am assuming just incase I'm preggie and my worry is that its too early to detect any HCG levels :think:(thankfully I ovulate early so have 12 days after 'O' to detect any HCG. Imagine if you are a late ovulator? BTW Some FS don't believe in NK Cell theory hence my 2nd opinion with another FS. There must be some truth as girls have got BFP after being treated for it.

I say test everything as time rolls along!!!.:)

Hi Charleotte,
Just to add my thoughts - have you had blood tests to rule out issues that may be inhibiting the embies sticking? After our 5th failed transfer I had further blood tests (not normally done until 8 failed transfers), and was found to have antinuclear antibodies which prevent implantation. I went on meds (asprin and heparin) and had success. These will be posts in the LTTTC that list the blood test myself (and others) have had...if you have not already had them it may be worth asking for them just to rule it out! If you want further info and cant find the posts, pls PM me and I'll dig out the info from my IVF file!

Good luck with the lap and I really hope that it does the trick!
FG

Hi Farmgirl - I looked at the other TTC section threads back pages & pages & couldn't find a heading with the whole total blood test list for fertility?

and I can't pm you - think I need more posts!..could you please send me the bloodtest list. That ANA I've read before so I definately want to get that done.
Hope you get this soon,
Thanks heaps:clap:

Hi charleotte

http://forums.bellybelly.com.au/foru...g-implant.html

This thread discusses a range of blood tests that some fellow BBers have had done in relation to implantation failure. Hope it helps.

There is also:
http://forums.bellybelly.com.au/foru...y-testing.html

You might also like to look through this thread. There's a great link provided by the lovely Baby Dreamtime (Page 5, post # 79) for an "Infertility Lab Tests' site which lists every conceivable test there is available which might also be of interest to you. I intentionally haven't included the link myself as I'm not sure it's allowed. I hope this all helps. Wishing you the very best.

I think the guys have given great advice there. Have a look of the two threads Dutchie posted over there.

From my personal experience, I've had 5 failed IVF cycles (bar one missed m/c) until I found out that my NK level is very high, which hinder the implantation and cause m/c. I wish I'd know earlier especially I am not at the spring chicken age either ;), so I haven't wasted those perfect embies in the past. So I do want to let all the ladies out there who have done more than 3 failed cycles to have these tests done before embark on another cycle. The tests are not expensive and you will get the result quite quickly.

Good luck.