
Karli Provost Goldstein
Esse Care and Wellness LLC
United States
Abstract Title: Unexplained Infertility, or Is It Just Endometriosis?
Biography:
Dr. Goldstein, founder of ESSE Care and who served on the board of the Endometriosis Foundation of America for six years, is a leader in minimally invasive surgery for endometriosis and complex pelvic conditions.
Dr Karli Provost Goldstein completed her medical training at Touro College of Osteopathic Medicine in NY and her residency in Obstetrics and Gynecology at Lenox Hill Hospital in NY. She further completed a three-year fellowship in advanced laparoscopic endometriosis surgery. She has a practice focused on restorative surgery for endometriosis, complex pelvic conditions, and wellness. Her practice aims to offer a boutique experience for patients with cross-collaboration in hormone therapy, nutrition, acupuncture, pelvic PT, therapy, and multidisciplinary surgery as needed.
Research Interest:
Unexplained infertility, a ubiquitous name for a vast possibility of causes, often leaves patients searching for answers. In up to 50% of these cases, pelvic diseases like endometriosis can be the cause. Fertility exploratory surgery was quickly tossed aside when rapid vitrification and IVF practices advanced in the last 20 years. It is time to re-examine the cost to the patient. IVF, often promoted as non-invasive and effortless for the patient, still is a high-cost commodity that may still not have success in many endometriosis patients. Exploratory fertility surgery with a step-by-step multi-system approach can provide valuable answers and therapeutic benefits to many patients. Operative hysteroscopy, coupled with robotic/laparoscopic examination of the entire abdomen with excision of endometriosis and restoration of the anatomy can be both diagnostic and therapeutic. Ovarian enhancement techniques can be offered for patients with premature ovarian aging. Pictures and video imaging of the anatomy after imaging studies prove unhelpful and can allow cross-collaboration between the teams to provide the best understanding of the case. A minimally invasive approach with general anesthesia and approximately a few hours provides long-term relief of symptoms as well as potential fertility benefits.