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Infertility

Multiple Fertility Issues, What Are My Chances?

09/05/2008

Question:

I have PCOS which I take Metformin for (and insulin levels are under control). I am of healthy weight range.

I have an ovarian cyst, which appears and disappears often. I have 3 fibroids but they are on the outside of my uterus.

I have just found out that I have blocked fallopian tubes and endometriosis. I have been told that I will need IVF. I am 27.5 years old. What are my chances of getting pregnant? And will I need to have my tubes removed? I also still have endo on my bowel and bladder, would this need to be removed for IVF to be successful??

Your help would be appreciated! Thanks in advance

Answer:

If your tubes are blocked at the front or proximal portion (where they plug in to the uterus), you can catheterize the tubes from inside the uterus in an attempt to open them, as long as the ends of the tubes are normal.  The procedure is called hysteroscopy (telescope looking into the uterus) with tubal catheterization.  At the same time, a laparoscopy (telescope through the bellybutton to look at the outside of the tubes) is performed.

If the tubes are blocked at the end, repair should be attempted only if the "fingers" or fimbria at the end of the tubes are still okay.  If the "fingers" at the end of the tubes are completely destroyed, removal of the tubes would be recommended followed by in vitro fertilization (IVF). 

With IVF, your chances to deliver a baby should be 40-45% per egg retrieval procedure.  It is not necessary to surgically remove endometriosis from the bowel and/or bladder before IVF treatment.  Finally, fibroids are usually remove only if they are very large, or are distorting the uterine cavity.

For more information:

Go to the Infertility health topic, where you can:

Response by:

Daniel B Williams, MD Daniel B Williams, MD
Formerly:
College of Medicine
University of Cincinnati