Endometriosis Diagnosis Without Surgery? Dr. Bruce Lessey

Written By Lora Shahine, MD

Are you struggling with unexplained infertility and wondering if endometriosis could be the missing piece? Have you been told that surgery is the only way to get a diagnosis? What if a simple test could offer answers without going into the operating room? 

In this episode of Brave & Curious, Dr. Lora Shahine welcomes guest Dr. Bruce Lessey, a double board certified OBGYN and Reproductive Endocrinologist with decades of research experience and over 150 peer-reviewed publications. Together they explore a groundbreaking question in reproductive medicine: can we diagnose endometriosis without invasive surgery?

Dr. Lessey and Dr. Shahine explain the science behind BCL6 testing, a biomarker found in the uterine lining that may signal inflammation linked to endometriosis. Dr. Lessey also shares how this research evolved from studying implantation markers to developing a potential non-invasive diagnostic tool, and why timing in the menstrual cycle is critical for accurate results. 

They also discuss the realities of delayed diagnosis, the connection between endometriosis and unexplained infertility, and how this test is already being used in clinical settings.

In this episode you’ll hear:

  • [1:21] Meet Dr. Bruce Lessey

  • [4:27] Why does diagnosing endometriosis take years?

  • [7:16] Introducing BCL6 testing

  • [16:20] Timing the biopsy window

  • [22:51] IVF outcomes study

  • [25:42] Fresh vs. frozen transfers

  • [27:22] Treating expected endometriosis

  • [28:44] Lupron and surgery explained

  • [30:42] BCL6 in recurrent pregnancy loss and recurrent implantation failure

  • [33:04] Progesterone resistance and benefits of letrozole

  • [40:48] Timing and testing pitfalls

  • [43:02] Future research and wrap up

Resources mentioned: 

Overexpression in Eutopic Endometrium of Women With Endometriosis. doi: 10.1177/1933719116649711.  

Endometrial BCL6 testing for the prediction of in vitro fertilization outcomes: a cohort study. doi: 10.1016/j.fertnstert.2017.09.017.  

Unexplained recurrent pregnancy loss and unexplained infertility: twins in disguise. doi: 10.1093/hropen/hoz021.  

This episode is sponsored by Cicero Diagnostics.

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This episode was produced by Audiotocracy Podcast Production.

Lora Shahine, MD

Dr. Lora Shahine, reproductive endocrinologist at Pacific NW Fertility and Clinical Assistant Professor at the University of Washington in Seattle, completed her residency in OBGYN at the University of California in San Francisco and fellowship in reproductive endocrinology at Stanford University. She is dedicated to educating and advocating for increased awareness of infertility, miscarriage, and the impact on environmental toxins on health through an active social media presence, teaching, clinical research, and authoring multiple blogs and books including best selling, ‘Not Broken: An Approachable Guide to Miscarriage and Recurrent Pregnancy Loss.’

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