Laparoscopy really necessary?

I was diagnosed with endo via laparoscopy several years ago. I don't have pain every month and feel that its not too bad. Now that we are TTC, my RE wants to do another lap.; I am hesitant as it seems like an invasive waste of time. I have a friend with severe endo and she got preg naturally; no surgery.

Anyone have any opinions?

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Personally I would have the lap. Unfortunately (or fortunately depending on how you look at it) pain is not a good measure of endo damage. Many women are only diagnosed once they TTC. Your friend is very lucky and unusual. She is the exception to the rule. There are many risks that are exaggerated for women with endo. If you were to get pregnant you have a higher risk of an ectopic pregnancy and can cause a lot pain during pregnancy. And you could waste a lot of precious time TTC without results. When I first began TTC I realized something was wrong and my OB refused to treat me until I'd TTC for a year. I was 33 at the time. I sought out a specialist (there are only a few true endo specialists in the country) who removed my endo using excision. During the surgery he also did an HSG and a D&C to make sure everything was healthy and ready for conception. Post-op he ran tests on my hormone levels and discovered I wasn't ovulating properly so he referred me to an RE. It turned out I had hypothyroidism and diminished ovarian reserve and my husband has severe morphology issues. By that time it was less than a year after my OB refused to treat me. If I had followed her advice I may never have gotten pregnant. Who knows how many eggs I would have had left. So obviously I am a big advocate of being proactive and covering all the bases. I'm also a big advocate of seeing a true endo specialist to remove the endo by excision rather than ablation which is what most docs, even ones who claim to "specialize" in treating endo, use.

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I would do the lap.
I have one scheduled for next month. I have no symptoms at all but I am putting money on the probability that I have extensive damage. Pain is not an indicator of severity when it comes to endo. It can "silently" cause infertility.
I hope all goes well for you.

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Yes, after working with a leading edge endometriosis treatment program, we came to recommend that even though women do not have pain, they have inflammation due to endo in the pelvic cavity. Excising endo improves fertiliy, even if it is IVF. Excision is an highly specialized process and less than 100 surgeons among the 52,000 treat endometriosis effectively. So you have to pick your surgeon carefully

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