How do you start the diagnosis journey?

I have never suspected I have endo, because I don’t have heavy or painful periods - However, I have struggled with infertility for years, and had an ectopic pregnancy a couple years ago. During the laparoscopy to deal with that my doctor (a fertility specialist ob/gyn) found what she described as signs of mild stage 1 endo and I believe she removed the lesions.

Since then I have had 3 failed rounds of ivf where euploid embryos did not implant. I have had Receptiva testing that came back negative, but I know that test isn’t 100% accurate and I am still wondering if I could have “silent” endo harming my chances for implantation.

Since doing more research I realized I do have some symptoms of possible bowel endo - severe and chronic constipation and bloating (GI doc diagnosed me with IBS unhelpfully), pain with deep penetration and sometimes pain with bowel movements. My current doc (same fertility specialist) doesn’t think I have endo, but I don’t know if she looked at my colon during the ectopic lap. I’m spinning out over the need to find out for sure. Both for fertility and the bowel issues.

Doing another exploratory lap with no evidence of “classic” endo feels extreme and I don’t know if insurance would even cover it. But have heard other imaging is not very accurate. I would love anyone’s thoughts on best next steps.