QC: Excision Surgery Before Fertility Treatments: The Expert Approach

Quick Connect Introduction

Speaker 1
0:00

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Meeting Our Expert Surgeons

Speaker 1
0:53

Today
.

Speaker 1
0:53

I'm

excited

to

welcome

two

of

the

most

accomplished

experts

in

endometriosis

care

to

the

table
.

First

we

have

Dr

Sadiqa

Bebehani
,

a

double

fellowship

trained

OBGYN
,

specializing

in

reproductive

endocrinology

and

infertility
,

as

well

as

minimally

invasive

gynecological

surgery
.

Dr

Bebehani

completed

a

second

fellowship

at

the

prestigious

Mayo

Clinic
,

where

she

mastered

complex

pelvic

surgery

using

both

laparoscopy

and

robotics
.

As

an

associate

professor

at

the

University

of

California

Riverside

School

of

Medicine
,

she

is

also

deeply

involved

in

medical

research

and

publications
.

With

her

rare

combination

of

training

in

surgery

and

infertility
,

dr

Babiani

is

uniquely

equipped

to

treat

complex

gynecologic

conditions

such

as

endometriosis

and

fibroids

that

affect

fertility
.

Speaker 1
1:34

We're

also

joined

by

Dr

Laura

Liu
,

a

highly

respected

board-certified

excision

surgeon

specializing

in

deep

excision

of

endometriosis
.

Dr

Liu

is

known

for

her

expertise

in

minimally

invasive

techniques

and

her

dedication

to

providing

patients

with

evidence-based

care

that

brings

long-lasting

relief
.

With

her

background

in

both

gynecology

and

robotic

surgery
,

she

has

helped

countless

individuals

find

a

path

to

healing

after

enduring

years

of

chronic

pain
.

Together
,

both

Dr

Bebehani

and

Dr

Loralu

bring

an

incredible

wealth

of

knowledge

to

today's

discussion
.

Surgery Before IVF Discussion

Speaker 1
2:06

Let's

dive

in
.

Do

you

notice

a

significant

difference

for

those

who

have

the

surgery

for

endometriosis

first
,

as

opposed

to

having

it

after

trying
,

like

IVF

or

other

methods

to

becoming

pregnant
?

Speaker 2
2:19

Absolutely
.

I

wouldn't

even

proceed

with

IVF

if

we

had

a

strong

suspicion

for

endo
,

because

the

surgery

may

save

them

the

cost

of

IVF
.

If

we

do

the

surgery

and

we

find

endo

and

we

treat

it
,

then

they

may

have

a

good

chance

of

getting

pregnant

naturally

without

IVF
.

And

if

they

don't

get

pregnant

and

we

still

do

IVF
,

their

chances

of

pregnancy

with

IVF

is

going

to

be

significantly

better

than

if

the

endo

was

still

there

and

we

hadn't

removed

it
.

And

I'm

going

to

add

one

more

thing

to

the

discussion
,

and

I'm

not

sure

if

Dr

Liu

does

that

or

not
,

but

when

I

have

my

PCOS

patients

go

in

for

surgery

for

endometriosis
,

I

actually

will

do

ovarian

drilling
,

since

I'm

there
,

you

know

might

PCOS and Ovarian Drilling Explained

Speaker 2
2:58

as

well
.

Speaker 2
2:58

Ovarian

drilling

is

a

surgical

procedure

that

was

done

very

often

in

the

older

days

when

fertility

treatment

was

not

as

available
.

So

we

would

go

in

and

surgically

poke

holes

in

the

ovary
.

Those

holes

are

meant

to

release

that

thick

layer

where

the

androgens

are

being

produced
.

Remember

I

mentioned

the

elevated

male

type

androgens

that

we

see

with

PCOS

patients
.

So

those

are

produced

by

cells

called

the

theca

cells
.

The

theca

cells

are

around

the

cortex
,

the

superficial

layer

of

the

ovary
.

So

if

we

poke

multiple

holes

in

the

ovary
.

That's

called

ovarian

drilling

and

it

actually

helps

women

ovulate

and

overcome

that

problem

of

elevated

androgens
.

We

don't

nowadays

take

women

to

surgery

just

for

that
,

and

20

years

ago

people

used

to

do

that
.

But

nowadays
,

because

we

have

so

much

more

advancement

in

medicine
,

we

give

them

pills

rather

than
,

you

know
,

take

them

to

the

OR
.

But

if

I'm

there

doing

their

endo

excision

surgery

and

I

know

they

have

PCOS
,

I

will

add

ovarian

drilling

to

my

procedure
.

Speaker 2
3:53

But

Sadiqa

it

has

to

be

confirmed

PCOS

Correct
.

So

if

I've

diagnosed

them

already

based

on

their

hormone

checks

the

Rotterdam

criteria

they

fit

the

diagnosis

of

PCOS
.

They

have

infertility
.

They're

trying

to

get

pregnant
.

We

also

suspect

endo
.

When

I

go

in

for

my

surgery

to

remove

and

treat

the

endo
,

since

I'm

there
,

it

literally

takes

10

seconds

to

poke

10

holes

on

each

ovary
.

Yeah
,

sure
,

and

there

are

no

side

like
,

no

significant

side

effects
.

Help
,

that's

the

data

is
.

You

know

it's

maybe

not

as

consistent

in

helping

get

pregnant
,

but

there

are

no

side

effects

or

harm
,

since

we're

there

already

doing

Episode Closing and Contact Info

Speaker 2
4:29

something

else
.

Speaker 1
4:29

Right
,

that's

a

wrap

for

this

quick

connect
.

I

hope

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