Hi Jo:
Although at that time I never had a lap to document it, I was told twenty one years ago that I probably had "extensive adhesions" in the left side of my pelvis. (and when I had my 2 laps last year they found I do/did have adhesions all around my sigmoid colon which is in the left side of your pelvis) Back in 1978 they came to this conclusion from the hysterosalpingogram. I know adhesions can't be diagnosed accurately from anything but surgery, but there must have been something about the xray that suggested this. They told me there appeared to be a mat of ahdesions on top of the left tube and a golf ball sized endometrioma between the left tube and ovary. Yet there was still free dye in the pelvis. My gyn told me that based on the xray, pregnancy through the left tube was probably 99 % impossible, but the right tube appeared to be open. 6 weeks later I was pregnant. So-I guess it really depends on where the adhesions are. If they block the tubes or impair ovulation or mobility of the fertilized egg they can cause infertility problems. He felt the endometrioma was responsible for irregular ovulation in my case, which is what brought me to him. I had no idea I had endo (I was 27 yrs old) or the adhesions, despite numerous physical exams by different doctors. You are probably going to have to get under the care of a gyn for this problem and probably one that specializes in infertility. I don't know anything about reproductive endocrinologists. I hear a lot of women talking about their RE-there weren't many of these back when I had fertility problems. I do think they seem to be biased towards in vitro fertilization and I wonder if that's because they're not surgeons. (at least most aren't) This wasn't an option back in the 1970's. When I became pregnant the first test tube baby was still in utero. I think you will find the attitude about surgery of gyns who have an interest in this area much different from your GP's attitude. This has been my experience. When I was being worked up for infertility I felt like there was no stopping them, they would try anything that increased the chance of pregnancy. My gyn suggested surgery right after the results of the hysterosalpingogram-in fact, it was scheduled for June 21st but I never made it. He never said "let's wait and see what happens". It was "let's do this, this, and this. And if that doesn't work, this this and this." This was my impression. My impression about doctors attitude about adhesions and pain control is much different-more like your GP's attitude that surgery could make it worse. I never heard my gyn say to me during the fertility workup "well, we have to be careful with surgery because it could make the whole thing worse." When you think about it, it could. Hope this helps. You can always e-mail me privately if you want to.
Chris