Is IVF my only option?

Dear Professor Winston,
I am 37. I have a 3.5 year old son who was conceived via a natural IUI cycle. My husband has never had any fertility issues. I have endometriosis. I have a 5cm cyst on my left ovary. My right ovary has been pretty normal. We have been trying to get pregnant for past 2 years for our second baby. We have tried several cycles of IUI (first natural, then with clomid and then with injectibles). Now the doctors are suggesting IVF as the best option. We are a bit reluctant to go directly to IVF as we are not yet confident about the long term effects of IVF. All my other fertility tests: blood work for ovarian reserve, sonogram to check the uterine lining, my thyroid levels are not. Doctors suspect there are adhesions because of my endometriosis and the sperm and egg are not meeting at all. Is IVF my only option to try?
Thank you very much for your time. D.

Dear D,

IVF is likely to be your best option but the 5cm cyst will need reasonable watching from time to time on ultrasound and may necessitate removal if advised.

Good luck
Robert Winston