Laparoscopy
Laparoscopy
Numerous surgical procedures are able to improve female fertility or can correct complications associated with the infertility. Laparoscopy is a minimally invasive surgical procedure that sometimes might increase chances of getting pregnant by removing abnormalities. Laparoscopy is performed to recover normal uterine shape, for removal of endometrial polyps, for removal of fibroids that might change the normal shape of the uterus, for removal of adhesions in pelvic and uterine cavities. If fallopian tubes are blocked with adhesion or are filled with fluid (known as hydrosalpinx), doctor recommends laparoscopic surgery for removal of adhesions. In some cases removal of fallopian tubes (salpingectomy) and/or blocking of tubes close to the uterus improves chances of pregnancy with IVF.
When to see a doctor:
One of the most important Question is, when to seek advice from Doctor: Sometimes it’s difficult to diagnose exact cause of Female Infertility. Many treatments are available, which totally depends on the cause and type of Infertility.
Signs of Infertility
The main sign of infertility is the inability of a couple to get pregnant naturally.
- Age of up to 35 years
Mostly doctors recommend to try to conceive naturally for a period of at least one year after marriage, before going for any testing or treatment.
- Age between 35 to 40 years
If you are not able to conceive after six months of trying, your doctor advice you with some tests and treatment through medicines or then IVF procedure.
- Older than 40 years of age
If you are in age group of 40 or above, your doctor recommends you straight away to go for IVF procedure.
Doctor might also want to start testing and treatment without any wait, if any of partner has known complications, or have history of any fertility related issue like irregular cycle or painful periods, inflammatory diseases of pelvis, recurrent miscarriages, under treatment for any immunosuppressant diseases, etc.
Diagnosis
If a couple is unable to conceive naturally within a reasonable time period, doctor will start evaluation followed by treatment of infertility. Evaluation of Infertility causes can be done through surgical or non- surgical testing:
Ovulation Testing:
Ovarian Reserve Testing:
Hysteroscopy:
Hysterosalpingography:
Laparoscopy:
How Laparoscopy is done?
Laparoscopy procedure is performed in hospital / fertility clinics under general anesthesia (GA). Doctor will provide you instructions for how to get yourself prepare for surgery. History will be taken about your health issues (if any), you will be asked not to eat or drink anything for 8 or more than 8 hours before scheduled surgery. When you get in to the hospital, OT nurse will attend you and give you medications or fluids through IV. Once you are shifted to the OT, the anesthetist will give you general anesthesia. Once anesthesia has taken its effect, the surgeon make a small incision beneath your belly button. Through this incision, your abdomen will be filled with carbon dioxide gas. This allows your doctor to view the organs and movement of the surgical instruments. Once abdomen is filled with gas, the surgeon will insert laparoscope through the incision. Sometimes, two or three small cuts are made to allow insertion of thin surgical instruments to make any repairs or move the organs for a better view. The surgeon easily evaluate the presence of any cysts, fibroids, adhesions, scar tissues or any abnormal growths. Surgeon will also look and access the shape, color, and sizes of reproductive organs. During whole procedure of laparoscopic surgery, you are under the effects of general anesthesia, and will not feel any pain. After recovery from anesthesia, you might experience a sore throat. Soreness is caused by the tube placed down through your throat to help you breathe during surgery. Soreness around the incision, tenderness of abdomen, bloating due to carbon dioxide gas and mild pain after Laparoscopy is quite normal. This should go away in a few days. You will be discharged from hospital to go home on the same day. Your doctor will prescribe you with some pain killers and antibiotics.
- Some less common risks may include:
The main sign of infertility is the inability of a couple to get pregnant naturally.
- Abdominal infection
- Adhesions formation
- Abdominal walls hematomas
- Rare but serious complications may include:
- Damage to Nerves
- Fatal allergic reactions
- Formation of blood clots
- Urinary bladder retention
- Damage to internal organs or any blood vessels present in the abdomen
Risks Associated With Laparoscopy:
Like other surgical procedures, risks are also associated with Laparoscopy. Common complications may include:
- Urinary bladder infection after the Laparoscopy
- Skin infection or irritation around incisional areas
Common Risks
- Abdominal infection
- Adhesions formation
- Abdominal walls hematomas
Serious Risks
- Damage to Nerves
- Fatal allergic reactions
- Formation of blood clots
What will be the results?
Depending on nature of complications, like adhesions, endometrial growths, cystic structures, and fibroids, the surgeon may decide to treat the problem during Laparoscopy, proper consents are taken from patients. In case, fallopian tubes are blocked, they can be opened sometimes.
Will Laparoscopy effects future fertility?
After Laparoscopy, surgeon will explain you about future options for getting pregnant either through medicines or IVF. If your fallopian tubes are repaired for any reason like after removal of fibroids, you might be able to conceive naturally.Also after removal of scars tissue, in case of Endometriosis or Pelvic Inflammatory Disease, you might be able to conceive naturally. And if after Laparoscopy you are not able to conceive naturally after trying for couple of months, you should visit doctor for future treatment
Laparoscopy for diagnosis of Infertility:
Laparoscopy for diagnosis of infertility is usually performed if completion of hormonal profile and ultrasounds doesn’t give conclusive result. Laparoscopy is mainly done in females with unexplained infertility. During Laparoscopy biopsy sample of out growths and cystic structures that are supposed to be the hurdle in natural conception are removed and sent for pathological testing. Laparoscopy can also be recommended for female patients who are experiencing severe pelvic pain, most common symptom of endometriosis. Laparoscopy is also used to remove scar tissues that can be a possible cause of abdominal pain.
When to go for Laparoscopy?
Infertility consultants suggest you to go for laparoscopic surgery in order to find out possible reasons for infertility. Generally, Laparoscopy is performed only after the completion of other infertility testing. However Laparoscopy should not be done as a part of routine diagnosis.
Major reasons for going under Laparoscopic Surgery may include:
- Severe Pelvic Infection
- Suspected Pelvic Adhesions
- Suspected case of Endometriosis
- Severe cramps during menstrual cycle
- Extreme pain during and after sexual intercourse
Often (but not always), if a diagnostic laparoscopy finds problems, the reproductive surgeon will repair, remove, or otherwise treat the issue right away. Laparoscopic surgery is also used to treat some causes of female infertility, like:
Hydrosalpinx
When hydrosalpinx is suspected, laparoscopy is done. Hydrosalpinx is a specific kind of fallopian tube blockage. Removal of the affected tube or adhesions can improve success rates of IVF.
Endometrial Deposits
Endometrial deposits are another suspected cause of infertility. Removal of Endometrial Deposits not only relieves the pain but also improves chances of natural pregnancy and better result of IVF.
Fibroid
Presence of fibroids might also causes pain, results in distortion of the uterine cavity, or blockage of fallopian tubes. Removal of fibroids also improves success rate of IVF.
Ovarian Cysts
Presence of ovarian cyst may also results in severe pain and blockage of fallopian tubes. Sometimes, cyst aspiration with the help of an ultrasound-guided needle is done. Removal of large number of endometrial ovarian cysts may reduce ovarian reserve.
Polycystic Ovaries
If you are a patient of Poly Cystic Ovarian Syndrome, consultant may recommends you to go for ovarian drilling. In laparoscopic ovarian drilling three to eight tiny punctures are made into the ovaries. Ovarian drilling enables women with Poly Cystic Ovarian Syndrome to ovulate naturally.
Blocked Fallopian Tubes
Surgery may also be used to unblock fallopian tube (s) or repair of fallopian tubes. Success rates significantly differs when it comes to repair of both tubes. Who were in past not able to ovulate even with the use of fertility drugs.
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