Failed IVF? Endometriosis Surgery First: Fix BEFORE Embryo Transfer
70% of women with infertility have undiagnosed endometriosis. Multiple failed IVF cycles usually mean endometriosis blocks implantation. Hormones suppress temporarily. Complete excision removes mechanical barriers. IVF success jumps 25% post-surgery. WhatsApp your IVF reports now for 15-minute case review.
Why Your IVF Keeps Failing (Surgeon Explains)
Women spend ₹5-15 lakhs per IVF cycle. After 2-3 failures, clinics push “one more transfer.”
Endometriosis creates physical barriers:
- Adhesions glue ovaries to bowel.
- Chocolate cysts distort tubes.
- Peritoneal implants create toxic environment.
- Hydrosalpinx blocks embryo transfer.
Hormones don’t remove these barriers. Surgery does.
The IVF Trap
Typical timeline:
- Year 1: Irregular periods → Hormones prescribed.
- Year 3: IVF recommended Cycle 1 fails
- Year 4: “One more cycle” → Cycle 2 fails
- Year 5: Endometriosis “discovered” → Surgery finally needed.
5 IVF Red Flags = Endometriosis Surgery First
- Poor embryo quality despite good AMH – Endometriosis oxidative stress kills embryos.
- Recurrent implantation failure – Adhesions prevent attachment.
- Normal AMH, few eggs retrieved – Chocolate cysts block access.
- Hydrosalpinx on ultrasound – Endometriosis tube blockage.
- Stage II+ on laparoscopy – Surgical clearance mandatory.
Score 2+ red flags? Pause IVF immediately. Surgery first.
Fertility Centers Push IVF. Surgeons Fix IVF Failure.
Fertility approach: Hormones → IVF → Repeat failure (15% success).
Surgical approach: Excision → IVF → 40% success.
ESHRE guidelines: Surgical clearance mandatory for Stage III+ before IVF.
IVF Patients: Exact 3-Step Protocol
Step 1: Specialist
TVUS misses 70% deep disease. MRI finds bowel/bladder involvement your fertility doctor overlooked.
Step 2: Complete Excision
25+ years excision specialist. 3D laparoscopy. Clear margins pathologically confirmed.
Step 3: IVF (if needed)
Post-excision success rate: 40% vs 15% untreated endometriosis.
Real Case: Age 35
IVF Cycle 1: 6 embryos, zero implantation.
IVF Cycle 2: Poor embryo quality.
Month 6: Excision surgery → All barriers surgically removed.
Month 9: Natural pregnancy confirmed.
STOP YOUR NEXT IVF TRANSFER Until You Answer These 5 Questions
- Has specialist MRI confirmed no deep endometriosis?
- Do operative notes say “excision” or “ablation”?
- Did pathology confirm clear margins?
- Was bowel/bladder cleared by multidisciplinary team?
- Is 6-month post-op ultrasound clear?
Answer NO to any question? Don’t transfer another embryo.
Failed IVF Endometriosis Surgery
Can endometriosis cause IVF failure?
Yes. 70% of infertility cases involve endometriosis. Surgery improves success rates 25%.
Should I do endometriosis surgery before another IVF cycle?
Mandatory for Stage II+. ESHRE guidelines recommend surgical clearance first.
How long after endometriosis surgery can I do IVF?
3-6 months optimal. Many patients conceive naturally post-excision.
About Dr. Vivek Salunke
Dr. Vivek Salunke is a senior laparoscopic surgeon based in Mumbai, India, with over 20 years of experience in endometriosis and fertility-preserving surgery.
He leads the Endometriosis & Pelvic Pain Centre and is known for his ethical, patient-centered care and advanced excision techniques.