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My wife had two miscarriages in 8th week (IUI -in Aug and December) last year. Our doctor suggested problems with egg quality and advised donor eggs. Her AMH was very low-0.01 ng/ml. and AFC around 9.We took a second opinion with another doctor in Jan 2013. On physical examination, doctor concluded that she has endometriosis- this was surprising as she never had any symptoms and no problems were identified in laproscopy in 2011 Dec.According to doc, endometriosis is causing egg quality reduction,which in turn leads to miscarriage. We underwent a naturopathy treatment. Her AMH is now 1.8 ng/ml. and AFC is 19 (total follicle count in both ovaries). However the doc is insisting on a hormone treatment (which will stop menstrual period for 4-6 months) or laproscopy to fix the endo, before any IVF/ICSI procedure.The doctor we consult is reputed and an expert in the field. But we are a bit confused, as many other doctors have ruled out endo. What is the definitive way to diagnose endo. and will endo cause miscarriage.How can my wife be pregnant through IUI if she had endo. Or would endo have been contracted after second miscarriage.

Hello Martin from India,

Endometriosis can ONLY be diagnosed by laparoscopy.  If your second doctor made the diagnosis by any other means, I would not trust this conclusion.

Endometriosis does NOT cause miscarriage.

Just based on these two conclusions that this second doctor made, I think he is misleading you.  He may be reputable, but he does not seem to be knowledgeable.

Good Luck,

Dr. Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program

Monterey, California, U.S.A.

for additional information check out my blog at check me out on twitter with me at @montereybayivf and facebook @montereybayivf.  Skype and internet comprehensive consultations now available via my website for those who want a more extensive evaluation that this site can accommodate


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Edward Joseph Ramirez, MD, FACOG


I am a specialist in infertility and advanced gynecological care. I can answer questions about infertility, gynecology related ills, menopause...virtually anything that affects women's health. PLEASE tell me where you are writing from as I am always interested.


I have been practicing as an Ob/Gyn and Infertility Specialist for over 23 years. Gynecology, advanced laparoscopic surgery, basic infertility, IUI's, IVF, reproductive surgery, and ovulation induction are all areas of my expertise. I am Board Certified. I have been doing In Vitro Fertilization in my clinic for 19 years.

American College of OB/GYN, American Board of Obstetrics and Gynecology, American Society of Reproductive Medicine, Society of Assisted Reproductive Technology, American Association of Gynecologic Laparoscopists, Fellow of The American College of Obstetricians & Gynecologists,Resolve-National Chapter, Open Path - Northern California, Board of Directors Monterey Medical Society

American Journal of Obstetrics and Gynecology, Wall Street Journal, Monterey Herald, SERMO, Women's Health and Fertility Blog

Medical Degree from Stanford University, Residency at Tripler Army Medical Center, Reproductive Training at Pacific Fertility Center, San Francisco

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