Some women will have a difficult time conceiving due to problems in their reproductive system. Problems range from a congenital malformation (birth defect) of the uterus or absence of reproductive organs, to abnormalities that develop over time, such as endometriosis, polyps, or fibroids…
These types of problems are usually found during a comprehensive fertility evaluation and surgery may be suggested to correct the situation. Several of the most common surgical procedures that are available are described below:
Hysteroscopy
Hysteroscopy provides a way for a fertility specialist or surgeon to look inside the uterus, and this procedure may be either diagnostic or operative. The hysteroscope, a very small, telescope-like instrument, is inserted directly into the uterine cavity through the vagina and cervix. The scope allows the doctor to see the uterine cavity and to diagnose conditions such as uterine septum (protrusion of the upper wall of the uterus into the cavity), scar tissue, endometriosis, uterine polyps, or uterine fibroids.
Diagnostic hysteroscopy is used to diagnose possible uterine abnormalities, and it may also be used to confirm the results of other tests, including a hysterosalpingography (HSG). Sometimes other techniques are used in conjunction with the hysteroscopy, such as dilation and curettage (D&C) and laparoscopy. A diagnostic hysteroscopy is often used to diagnose certain conditions such as infertility, abnormal uterine bleeding, repeated miscarriages, fibroid tumors, polyps, and the procedure may even be used to find out-of-place intrauterine devices (IUDs).
Rather than having open abdominal surgery, an operative hysteroscopy may be used to both diagnose and treat certain conditions such as uterine adhesions, septums, or fibroids as they can often be removed through the hysteroscope.
Hysteroscopy allows diagnosis, as well as treatment of the anatomical problem. Depending upon the seriousness of the condition, this procedure can be performed either in a doctor’s office or in a hospital setting. This procedure is considered outpatient surgery, and therefore it does not warrant an overnight stay.
Laparoscopy
Laparoscopy is a minimally invasive surgical technique that allows doctors to view and evaluate the pelvic organs. During this procedure, a small, telescope-like instrument called a laparoscope is inserted through the belly button. The laparoscope is a one-half fiber-optic rod with a light source and video camera. The video camera permits the surgeon to see inside the abdominal area on video monitors located in the operating room.
Depending on the reason for the laparoscopy, the physician may perform by inserting various instruments into the laparoscope while using the video monitor as a guide. The video camera also allows the surgeon to take pictures of any problem areas he discovers. Some of the conditions that may be found with laparoscopy include endometriosis, scar tissue, tubal damage, hydrosalpinx (a fluid-filled fallopian tube), uterine fibroids, ovarian cysts and tumors.
Laparoscopy is an outpatient procedure and often the surgeon can correct the problem at the same time it is being assessed. Before surgery, an ultrasound examination is used to define any potential problems. In most cases, patients are able to return home a few hours after the laparoscopic procedure has been completed.
Laparotomy
An exploratory laparotomy is the name given to an abdominal surgery used to observe the organs and tissues of the abdomen when a diagnosis has not yet been made. If the source or cause of an abdominal problem is not apparent, a visual examination of the abdominal cavity is often helpful.
With the laparotomy procedure, an abdominal incision is made to allow access into the abdominal and pelvic cavities. Typically, a laparotomy requires a longer recovery time, since the opening is made through the muscles and the fascia that protect the abdominal and pelvic organs. Sometimes, though, the surgeon is able to perform a mini-laparotomy with a smaller incision; if that is the case, the patient is often allowed to go home after a short observation period.
Laparotomy allows surgeons to handle bigger pelvic problems, such as extremely large ovarian cysts, uterine fibroids, or even a ruptured ectopic pregnancy with uncontrolled hemorrhaging. When the decision to proceed with a laparotomy is made, it should be discussed in detail before the surgery is scheduled, so the patient understands both the benefits and the risks, as well as any possible alternatives.
If you have been unsuccessful in your attempts to conceive and you are looking for a reproductive specialist, the Center of Reproductive Medicine (CORM) helps infertile couples in the southeast Texas area with two full-service fertility clinics in Webster and Beaumont. CORM is a renowned fertility center with one of the highest success rates and some of the most competitively priced infertility services available. The fertility specialists at CORM are dedicated to providing a nurturing and positive experience for all fertility treatment patients. The professional staff at the Center of Reproductive Medicine is dedicated to examining and investigating the specific cause of each fertility issue, recommending and implementing the best fertility treatment options available.