Potential tubal issues - is laparoscopy worth it?

[Bella000]

Hello, I wondered if anyonen had a similar experience or some advice. My husband and I have been trying for a baby and my chlamydia antibody test came back abnormal, suggesting previous infection (but no longer active). I had no idea but for this was recommended I have a laparoscopy to investigate and treat any issues found. I'm on a visa (until this August when I can apply for a permanent residency/ILR) so need to fund this as a private patient. This costs nearly £4500. We could just about pay this but worry as we're also told that even if the tubal damage could be addressed by this laparoscopy the function might still be damaged and the chance of us naturally conceiving is 20-25%, leaving IVF as our only option for conceiving. With £4500 we could do a cycle of IVF via a private route - what would you do? Should we go for a laparoscopy to get a clearer idea of the tubal damage hoping for the best and we can have a baby naturally, or should we just go for an IVF using the fund? We note that IVF success rate is also not that high - but at least we'd know that some steps would've been done for actual pregnancy?

Another thing I should note is that if I want to get IVF through NHS it's likely that I need to have this laparoscopy to get a diagnosis (or not). The problem with this is that the wait time for a laparoscopy is apparently 6-9 months. We are told that there's no wait list for IVF so if we do get a laparoscopy privately before I get a residency and become eligible for NHS funded IVF, that means that we can try for a couple of cycles without help and if no joy we could go straight to IVF through NHS.

Not sure if my question is clear but I do hope someone can help - thanks so much for reading this through, and I hope you are coping well and have all the support you deserve.

[JA-fnuk Partner Nurse Fertility Network UK]

Difficult decision to make - but think going straight to IVF not a good idea - if there is a concern with your tube it can reduce the chances of implantation happening Hope you get more replies this is a great forum for support

Thinking of you

Janet

[Bella000 in reply to JA-fnuk]

Thank you so much Janet, much appreciated 🥰

[BeeRainbow]

Hi Bella000 I had a similar issue - unexplained infertility and it was suggested I have laparoscopy but this would need to be private due to NHS wait list being years long in my area (Wales). I chose to go direct to IVF but I'm not sure whether it was the right choice and still wonder about that laparoscopy. It is frustrating not knowing what's wrong and we've essentially gone into IVF 'blind'. I will follow this thread and see if anyone else comes up with suggestions. Wishing you all the best on your fertility journey. x

[Bella000 in reply to BeeRainbow]

Hi BeeRainbow, I am so sorry you had to go through this as well - it's unbelievable that they have years worth of waiting list. Must've been very hard for you. Hope there's someone who has some advice for us - thinking of you and all the best to you too xx

[Jane8412]

Hi- I was in a slightly different situation but the advice they gave me may be helpful. I had PID and infection which was left untreated for a few months before finally being treated when I was about 20. Due to this there was concern I had blocked tubes when I couldn't conceive naturally. When I was referred to the fertility clinic for tests at 35 I queried having a HSG to check my tubes. They told me that if there was a blockage they may be able to pick this up on the normal scan they did of my womb but since nothing was picked up and my AMH was so low they recommended moving onto IVF sooner rather than later. Their thought process was that if my tubes were blocked then I would need IVF anyway so having it done wouldn't add any value. I queried about what if my tubes were blocked and leaking fluid (I had read this could cause issues with conception). They said this should be picked up as they would generally see a hydrosalpinx on the internal scans they do. That is just my clinics advice but I decided to go straight to IVF as I was 35 and worried about my lack of follicles. I had my 1 round on the NHS which did not work but then I had a private round with the same clinic which I now have my son from (only got 2 eggs and only 1 fetilised). When he was just over a year I got naturally pregnant (big surprise) so one of my tubes must be clear.

Also worth looking into your local CCG and what they provide in regards to IVF. I know some have restrictions on NHS rounds if you have already had private rounds but some do not.

good luck xx

[Bella000 in reply to Jane8412]

Thank you so much for sharing this and so pleased that you have two children now. Your clinic's thought process does sound like mine - but my clinic didn't advise so or say they could see any damage or not from the scan, so it's really confusing. My CCG would allow max 2 transfers regardless of it private or NHS so if I do a private IVF and 2 transfer I can't do NHS but if I do private and 1 transfer I can get 1 transfer from NHS... anyway, thank you so much again for sharing it. It's really helpful. xxx

[Jane8412 in reply to Bella000]

You're welcome

It's really unfair that some people are pushed to go private due to long NHS waitlists and that this then effects their ability to access a round on the NHS. Especially when we have such a feeling of urgency when it comes to treatment! I wouldn't be surprised if some people didn't inform their NHS clinic if they had already done private rounds just to get around this. Not really ethical but when money is tight and you are desperate to have a child I can see why people would be tempted. I was lucky in that there was a very short wait for my NHS round and then I was able to afford to go private immediately after. Unfortunately it isn't like that for everyone. It's really sad.

Sending you lots of luck for whatever you decide xx

[Bella000 in reply to Jane8412]

Thank you Jane, it is indeed isn't it - I just hope there's some compassion or understanding in policy that these things are really emotional and important, not just a life choice. As an immigrant on a visa applying for visa is not cheap either and on top of that having to cover the cost for these treatments is really just so much. Thank you for your compassion honestly, I am so so greatful. Sending you all the best too xxx

[Jane8412 in reply to Bella000]

oh yes - the cost of visas are extortionate too! It’s a lot of added pressure which doesn’t help with the stress levels. I really hope everything works out for you. Xx

[Emilye92x]

Hi Bella!Sorry I can't shed a huge amount of light on what you should do laprascopy wise - however when we were going through out fertility investigations I was found to have antibodies to chlamydia too

They initially said they were so low that it wouldn't be the cause of our infertility, but it was 😂

I had a HSG test (they flush a dye through your tubes to check for patency and take xrays at the same time) and found that both my tubes were badly scarred, totally blocked and unrepairable - caused by would you believe it the chlamydia!

We were told that because of this we wouldn't be eligible for IVF on the NHS as the scarring and blockage of the tubes creates a toxic fluid that spills into the uterus which can destroy/flush out an embryo that is placed in the IVF process. We were then told I could have my tubes removed on the NHS to qualify for IVF but the wait was 18 months long. We were fortunate to have been given money by family and chose to have the surgery done privately, and 1 failed fresh transfer and 1 FET later I'm due to have our baby boy this Sunday!!!

Hope that my journey is of some help to you please feel free to ask any questions if I've not been clear about anything, and good luck with everything🤞💕 xx

[Emilye92x in reply to Emilye92x]

Oh also just to add - please do a little more research on this but I think if you've had private IVF cycles you won't qualify for any NHS cycles! And also the HSG test that I had was part of our fertility investigations and is far less invasive than a laprascopy so it may be worth asking your clinic for the wait times on that/the private cost of having it checked x

[Bella000 in reply to Emilye92x]

Thank you so much for sharing that Emily - I couldn't be more grateful but at the same time I am so sorry that you had to go through all that. I'm so happy that you'll be a mum in a few days (how exciting!!) and really hope that everything goes smoothly. I did a bit of googling and my CCG seems to allow max 2 transfers including private so I could try private IVF and if I don't get 2 transfers I can still get NHS funding to match 2 transfers, but again hearing about the impact of tubal issues to IVF maybe I should just do laparoscopy hoping nothing serious is there. Our clinic seems to do HyCoSy instead of HSG but don't offer this privately (I could go to another clinic but the cost is not cheap - £500+... ), and I heard that this would only detect blockage not adhesion and hence laparoscopy is the best option to clear the damage completely if there's any. Anyway, thank you so much again, and all the best for your journey xxx