Q: I am 31 years old, married for 6 years and have no child. Laparoscopy, Dye test D&C was done two years back. Tubes were normal, uterus was normal, no fibroid, ovaries normal in size, moderate endometriosis in uterosacral ligaments and peritoneum. I am on gonablok 200 mg twice/day since 6 months. A repeat laparoscopy was done. The result was no endometriosis; have been on Fertyl 50 mg for 5 cycles. TSH moderately high, on eltroxin for 4 years. FSH & LH are normal, prolactin is border line, blood sugar is ok. Result in both cycles: unruptured follicle. My doctor advised puncturing holes in ovary through laparoscopy/IVF. My query is what are the options for me and what is the best option?

A:You seem to have Luteinised Unruptured Follicle for which only IVF seems to work. Incidentally an Ovarian endometrioma would also lead on to follicular entrapment and in this case a good operative laparoscopic procedure should help out.