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Infertility/Fertility/stage IV endometriosis & pregnancy


Hi Dr
I was diagnosed with endometriosis in 2007 at age 21. I am now 27, I have undergone multiple surgeries to restore my quality of life. X5 laparoscopyx1 laparatomy.I have re occurring cysts on my ovaries& a fibroid, but dr says he is not worried about the fibroid.
I have tried getting pregnant since 2009 with no success,everytime I use clomids the cysts grow. Last year I took the Zoladex injection for 6 months,had a laparoscopy before the 6months were up to look if all is in order in there. My periods did not come back naturally & scan showed that the lining of my uterus was to thick then he gave me provera.which worked.

The pain is back again at the time around of my period,before & during. My feet hurt,my hands& feet swollen&my pelvic area hurts, especially on the left hand side.I'm using clomid again but still no success. I'm also suffering from re occurring bladder infections for months & my gynaecologist has referred me to a urologist who has scheduled a ct scan& a scope for next month.
Do U think I will ever fall pregnant?

Hello Nolitha from South Africa,

With a diagnosis of severe endometriosis (stage IV) and a history of multiple pelvic surgeries, your chances of getting pregnant by natural means (Intercourse or IUI) is probably less than 1%.  It is not zero, however.  The treatment of choice in your case, and what I would strongly recommend if you were my patient, is to go directly to IVF.  This treatment will bypass the endometriosis and pelvic scar tissue and allow you to become pregnant, which by the way is a very good treatment for endometriosis.  If you are sincerely interested in getting pregnant right away, I would stop wasting time with your gynecologist and go see an Infertility specialist that does IVF.  Make sure it is a top notch clinic.

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, California Medical Association, American Association of Gynecologic Laparoscopists, Fellow of The American College of Obstetricians & Gynecologists

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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