Fertility Enhancing Surgeries
Diagnostic Laparoscopy
Laparoscopy, also called diagnostic laparoscopy, is a procedure used to examine the organs located in the abdomen. In the case of women, this includes the reproductive system. In the procedure, a laparoscope, a long thin tube with a light and a high-resolution video camera at the end is inserted into the abdomen through a small surgical incision. The doctor manipulates the device to show the areas and organs that need to be examined and the picture is shown in real-time on a video monitor. The doctor is able to visually examine the interior of the abdomen without the need to perform open surgery.
The benefits of diagnostic laparoscopy include:
- Providing the doctors a real-time look at the organs
- Avoiding open surgery
- For the patient, it means a quick recovery and return to work.
- The discomfort and recovery time are greatly reduced as compared to open surgery
Endometriosis resection
Endometriosis is a condition that occurs when the tissue that lines the inside of a woman’s uterus also grows outside it. The symptoms of the condition include:
- Severe pelvic pain that is not relieved by medication
- Difficulty in getting pregnant
- A growth is noticed in the pelvic region.
Endometriosis resection is the term for surgery to remove the unwanted tissue. The surgery, although fairly common, may affect a woman’s ability to get pregnant in the future. The specialists at NMC will first diagnose the extent of the problem and examine treatment options. Patients are briefed on the treatment choices available to them and helped to make a decision that is right for them.
Tubal Recanalisation
If a woman has opted to go in for tying the fallopian tubes as a family planning method and later decided that she wants to conceive again, this procedure is done to reverse the previous procedure. It involves the use of microcatheters (very fine, flexible plastic tubes that are visible under X-ray) which are guided into place by microguidewires that are inserted through the vagina. A small amount of dye that will enhance the visibility is injected through the catheter. Once the cause of the place where the tube has been tied is found the tubes can be opened again out so that it are no longer blocked. The process is done on both of the tubes.
Myomectomy
A myomectomy is a surgery that is performed to remove uterine fibroids. These are non-cancerous growths that commonly appear in the uterus, most often in women of childbearing age. Unlike a hysterectomy, where the whole uterus is removed, in the case of a myomectomy, only the fibroids are removed and the uterus is reconstructed if required. The procedure is performed when fibroids have been diagnosed and the condition affects a woman’s normal activities. Subject to medical viability and the patient’s safety and health, this procedure is preferred over hysterectomies for women who are of childbearing age and plan to have children.
An open myomectomy is generally done with a horizontal incision low down on the abdomen. This will allow the surgeon to access the uterus and remove the fibroids. The typical post-operative hospital stay is 2 to 3 days, followed by 4 to 6 weeks of rest and recovery at home.
Adhesiolysis
Scar tissue that becomes excessively thick or forms into lumps is known as abdominal adhesions. The most common cause of this condition is previous abdominal surgery. Other causes include the normal scar formation over a surgical incision, pelvic inflammatory disease, Crohn’s Disease (chronic bowel inflammation), diverticulitis, peritonitis, radiation (from cancer therapy). Generally speaking, these adhesions do not cause any health problems and often remain undetected until they are found in the course of some other diagnostic investigation. They can however cause some health problems including:
- Bowel obstruction
- Chronic pain in the abdomen
- Infertility
The surgical procedure involves making an incision on the lower abdomen, locating and removing the adhesions, repairing any connections between organs that may have been blocked, and then closing the incision. Because symptoms often do not appear and when they do, they are common to many other medical conditions, diagnosis and then treatment requires the expertise and experience that the doctors at NMC possess.
Ovarian Drilling
Women with polycystic ovarian disease (PCOD) do not have regular menstrual periods which decreases their chances of becoming pregnant. Hormone treatments may increase the regularity but could further reduce the possibility of pregnancy. If medication is not successful a surgical procedure called ovarian drilling is often used. Women with PCOD usually have ovaries with a thick outer layer that produces excess testosterone which is a cause of menstrual irregularity. Ovarian drilling is a laparoscopic procedure where a small incision is made near the navel. A laparoscopic camera and special tools are used to break up the thick outer surface and lower the amount of testosterone produced thereby increasing the chances of pregnancy.
Chromopertubation
This is a laparoscopic procedure to detect blockages in the fallopian tubes that could be the reason for a woman not being able to get pregnant. A blue dye is injected into the fallopian tubes. A camera-equipped surgical device is inserted through a small incision under the navel. The camera will allow the surgeon to see if the dye comes out at the end of the tube. If so, there is no blockage. If the dye does not come out, then the surgeon will order further tests to determine the right cause of action to increase the possibilities of pregnancy.
Ovulation induction
This is a process that involves the use of medication to treat irregular periods or the absence of periods. The normal ovulation cycle is 28 days, but intervals of 21 to 35 days are acceptable. When ovulation is outside accepted limits or is irregular the possibilities of pregnancy are greatly reduced. After tests and examinations, the doctor will decide if a patient is a good candidate for the procedure. If so, there are several drugs that may be prescribed to regularize ovulation. The doctor will decide on which will be right for the patient. Ovulation induction is a popular initial fertility treatment because it is noninvasive.
Intrauterine Insemination (IUI)
This s a form of artificial insemination that is used to treat infertility. The procedure uses sperm that has been washed and concentrated which are then placed in the uterus at the time when eggs are released to maximize the possibility of pregnancy. The procedure is often used in cases of:
- Unexplained infertility
- Endometriosis-related infertility
- Mild male factor infertility (subfertility)
- Cervical factor infertility
- Ovulatory factor infertility
- Semen allergy
- Or when donor sperm is required.