When Should a Patient Consult With Us?

Over the years, Dr. Vidali’s work with women experiencing autoimmune-related reproductive challenges has led to a powerful and important insight: many of these issues are not just immune in origin—they are often Expressions of Endometriosis and Adenomyosis, two deeply underdiagnosed conditions that interfere with fertility, pregnancy, and immune function. These conditions are more than gynecologic diagnoses—they are often physical manifestations of a deeper immune imbalance. When endometriosis or adenomyosis is present, it is not only a structural issue, but frequently a sign of an underlying autoimmune response that must be addressed.

At BRI / ESSI (Endometriosis Surgical Specialists, formerly BRI), we bring a unique combination of Surgical Expertise and Immune-Informed Insight to each case. With more than 25 years of experience in women’s health, fertility, and immune treatment, we understand the pain and isolation many patients feel—and we’re here to offer answers. While we have helped thousands of patients manage immune-related pregnancy loss, our practice now leads with Advanced.

Here are the most common reasons to seek a consultation with our team:

Have you experienced failed IVF cycles despite transferring good-quality embryos?

When embryo quality looks excellent and IVF still doesn’t work, it’s a strong indication that something else may be interfering with implantation or early development. We often find that undiagnosed endometriosis, adenomyosis, or immune-related inflammation are the missing links.

At BRI / ESSI, we specialize in identifying these hidden factors through advanced surgical evaluation and pelvic mapping, helping patients finally move forward after repeated disappointment.

Do you have a history of endometriosis along with recurrent pregnancy loss or IVF failure?

Endometriosis can profoundly impact fertility, implantation, and early pregnancy.

At BRI / ESSI, we specialize in uncovering and treating endometriosis through advanced excisional surgery, giving patients a true path forward—often for the first time.

Are you receiving immune therapy without a comprehensive pelvic evaluation or surgical assessment?

Immune therapy can be an important part of a patient’s care—but without ruling out conditions like endometriosis or adenomyosis, the most critical contributor to your reproductive challenges may go untreated.

These conditions are often the immune system’s physical expression of deeper dysfunction and require surgical evaluation to be identified and addressed. If you are currently receiving immune treatment (See Diagnostic Testing Page) without a full pelvic mapping or surgical consult, you may be missing a key piece of your reproductive picture.

Have you experienced two or more early miscarriages—even before a heartbeat was detected (such as a chemical pregnancy or blighted ovum)?

These losses are often dismissed as "common," but our experience shows that underlying endometriosis or adenomyosis may be silently interfering with implantation and early pregnancy development.

Have you been diagnosed with PCOS and experienced multiple miscarriages or late pregnancy complications?

PCOS can negatively affect immune regulation and placental development. We look beyond hormonal management to address immune and surgical factors that may be overlooked.

Have you experienced a pregnancy loss after a fetal heartbeat was detected—without a confirmed genetic abnormality?

This is a strong sign that a deeper issue may be present. We often uncover treatable uterine or immune factors through surgical evaluation.

Have you had a pregnancy loss that was tested and found to be genetically normal after a D&C—even if it was your first?

A genetically normal pregnancy that ends in loss is a red flag that something beyond chromosomal issues may be involved.

Have you experienced a stillbirth (a pregnancy loss after 20 weeks) and were told there was no clear explanation?

Many "unexplained" stillbirths may be linked to undiagnosed immune or inflammatory conditions that surgical insight can help uncover.

Have you experienced failure of a donor egg or donor embryo cycle?

With high-quality embryos, failure may point to a uterine or immune environment issue, not the embryo itself. Our advanced pelvic mapping process combines physical examination, high-resolution ultrasound, and direct interaction with your surgeon to detect subtle but critical abnormalities—such as hidden endometriosis or adenomyosis or uterine inflammation—that may be impacting your success. Surgical mapping and evaluation can offer the clarity needed to move forward with confidence.

Do you have an autoimmune disease and have experienced an early pregnancy loss or late complication such as preeclampsia?

Autoimmune conditions can quietly affect implantation and placental development. Our team brings surgical and immune insight together to guide your care.

Have you experienced pre-eclampsia, placental abruption, or pre-term labor in a previous pregnancy—followed by miscarriage or reproductive failure?

These complications are often severe inflammatory responses triggered by underlying autoimmune disorders, and they may be silently impacting your ability to carry a healthy pregnancy. This combination strongly suggests underlying inflammation or immune dysregulation that can and should be addressed—both surgically and immunologically.

Have you had a healthy baby boy, followed by multiple pregnancy losses?

This pattern can sometimes indicate immune sensitization or imbalance that develops after pregnancy. Our team is experienced in recognizing and managing these complex dynamics.

Are you under the age of 40 and have been told you need donor eggs—or that you have unexplained poor egg or embryo quality?

Before moving to donor eggs, a full surgical evaluation may reveal treatable causes such as endometriosis, adenomyosis, or chronic inflammation.

Do you have a child on the autism spectrum and are trying to conceive again—especially if you’ve experienced a miscarriage?

Emerging research links immune dysregulation with both pregnancy loss and neurodevelopment.

Have you experienced failure of an IVF cycle with genetically normal (PGS/CGH-tested) embryos?

When embryo testing shows that your embryos are chromosomally normal, yet the cycle still fails, it’s a clear sign that something beyond genetics may be interfering. In many cases, undiagnosed endometriosis, adenomyosis, or an immune-mediated implantation issue may be at play.

Before considering another IVF cycle, we recommend a comprehensive surgical assessment to rule out these immune-triggered gynecologic conditions.

Why a Surgical Evaluation Matters

Many of these patterns point to Undiagnosed Endometriosis or Adenomyosis, which can interfere with implantation, embryo development, and immune tolerance during pregnancy. These conditions are rarely diagnosed through testing alone—and are often invisible to Traditional Imaging, Sonogram, Doppler Study and Pelvic Mapping.

At BRI / ESSI, we specialize in Surgical Pelvic Mapping, Excision of Endometriosis, and Advanced Reproductive Surgery—helping patients finally get the answers and outcomes they deserve.

Take the Next Step

If any of these situations resonate with you, we invite you to schedule a consultation with our team. Whether you live nearby or out-of-the-area, we offer both in-person surgical evaluations and virtual consultations to determine the best path forward.

Request a Consultation or Email our Team at [email protected]

You don’t have to live in Pain, Confusion, or Fear of more Loss. We’re here to help.