As I said, endometriosis does cause poor quality of the oocytes and poor fertilization rate, poor implantation rate. IVF does bypass the endometriosis to a very big extent, but not necessarily it would cause a poor quality of the oocytes. With supplements of estradiol and progesterone in case of the corpus luteum deficiency that is caused by endometriosis then, implantation, if it takes place, could be supported. There is a small percentage that endometriosis affects IVF, not a big percent. That’s why your doctor has told you that IVF surpasses endometriosis, but it does. As I said in the presentation, after certain attempts of IVF, instead of going through another and another psychologically wise, body-wise, and cost-wise it doesn’t make any sense.
There should be something there, an underlying disease such as endometriosis that should be cured. In order to investigate everything, a laparoscopy would be suggested, but it all depends on the age. If a woman is 40 years old and older, for example, it could be suggested again to have a laparoscopy. There is also the poor quality of the eggs because of age, so it depends, we put many factors together to make a conclusion and suggest to go through laparoscopy.
Not all patients go through that, mainly younger women, but of course, women after recurrent implantation failure of older age, but the hormonal profile is very important to see that is fine, we would not suggest laparoscopy to everyone. As you’re getting treatment for endometriosis by suppression to help you with an answer, I would need to know your age, I would ask how is your hormonal profile before suppressing, is the AMH fine because suppressing for a few months could also suppress the hormonal levels more, which would not be good as well. Even if you would go for IVF later on, so I would ask all these questions before giving a final answer.