Since three IUIs have not worked there is a possibility for underlying issues. With me, the issue could potentially be endometriosis which can only be detected through laproscopic surgery. Or there could be an unknown issue with the sperm. Or both.

This is interesting. Dr. L told me even men who have absolutely normal sperm counts can have problems fertilizing the egg. In 40-50% of male fertility issues doctors cannot detect the problem. Especially if the male has undergone hormonal, chromosomal, and obstruction testing and all tests have returned back normal - which Dave's did.

Dr. L said some people, after 3-4 unsuccessful IUIs, will jump right to in-vetro fertilization (IVF) without laproscopic surgery.

Dr. L said a woman with endometriosis has a lower success rate of pregnancy with IUI. He said there is a big controversy going on right now about endometriosis lowering the success rates of IVF. Dr. L is on the fence concerning this issue.

Our next step is laproscopic surgery on November 6th. I am trying not to think too much about it. I know it is an out-patient procedure but I'm the girl who has never been under the knife and never been under general anesthesia. So I am just a bit nervous about it all. But, my insurance covers the procedure and we feel at peace that this is the next step.

After that procedure, based on what is found, we will have another decision to make. Go back to IUI or proceed into the world of IVF?

If endometriosis is found, I could have it cleaned out and then Dr. L said we could do one or two more cycles of IUI. The only thing with this is if there is an unknown sperm issue, doing more IUIs won't by-pass the issue. On the other hand, proceeding to IVF if I do have endometriosis, would by-pass my issues and a potential sperm issue.

If endometriosis is not found we can conclude that there is probably a sperm issue and proceed to IVF.

Yesterday's doctor visit was very long and I took in a lot of information. Which is why I am so grateful Mama could go with me to take notes. As Dr. L spoke, I listened and Mama took 4 pages of notes!

We press forward. Keep praying!

- Elaine