Fertility Enhancing Surgery, is a surgery done laparoscopically or hysteroscopically to enhance fertility and to correct complications like Endometriosis, Fibroids, Dermoids etc.
These surgeries corrects the problem by rectifying the underlying cause that prevent the woman from getting pregnant like endometrial tissue, cyst.
You know it is time to go in for a Fertility Enhancing Surgery if you haven’t been able to conceive within a reasonable period of time. But ensure that you do so only upon evaluation by your doctor for treatment of infertility. Both you and your partner should be evaluated through a thorough physical examination.
There are broadly two types of fertility-enhancing surgeries - Laparoscopy & Hysteroscopy.
Laparoscopic surgeries are minimally invasive procedures that use the insertion of a thin tube called a laparoscope with a light and camera on the top to view inside the abdomen.
In a Hysteroscopy, the tip of a hysteroscope is inserted into the vagina and moved to the uterus through the cervix, and once it reaches the uterus, a surgeon can look for possible abnormal changes inside the uterus and rectify the problems.
Diagnostic Hystero Laparoscopy:
In this day-care procedure, a small operation is done under local anaesthesia where a laparoscope is introduced into the abdomen, the uterus, tubes, and ovaries, and a pouch of douglas and bowel is visualized. Small corrective operations such as ovarian drilling, adhesiolysis, excision of fibroids, removal of endometriomas, and cysts are also done. The uterine cavity is visualised for polyps, fibroids, septum, etc. which are then diagnosed and treated. Tubal Ostia can be visualized and Cornual block removed if needed.
At the end of the procedure, the diagnosis of Infertility is definitely established and a treatment plan is recommended. Hystero laparoscopy is recommended for all cases of Infertility. Diagnostic Hysterolaparoscopy is the golden standard for basic investigation and treatment in fertility, as it not only helps identify the cause of infertility but also provides a solution to the problem in the same sitting.
Ovarian Drilling:
When a woman stops responding to fertility medicines in case of PCOS, an ovarian drilling can bring on ovulation. Patients suffering from PCOD are taken up for surgery after strict pre-operative diagnostic work-ups. When a patient satisfies all investigations, the first line of management is advised which includes diet control, weight reduction, and increased physical activity. Before drilling, we check the ovarian reserveof the patient. Only if it is very high, we will drill, otherwise we do only a diagnostic laparoscopy.
After a fair trial of medical management, if the patient still does not become pregnant, laparoscopic ovarian drilling is considered. Most of the women will ovulate the very next month after PCOD drilling and are able to achieve pregnancy within 3-6 months of the surgery.
Laproscopic Myomectomy:
Myomectomy is the surgical removal of fibroids from the uterus and help the women to get pregnant naturally.
Laparoscopic Surgery for fibroid is regarded as the best treatment option for fibroids, can be performed successfully without having a big scar.
Laparoscopic Cystecomy:
Laparoscopic Cystecomy is a procedure that removes Ovarian Cysts after a thorough evaluation via an ultrasound of a pelvis or blood test. A cyst of any size can be removed laparoscopically while saving the ovary.
Laproscopic Ectopic Pregnancy Removal:
In some cases, women develop pregnancy in the tubes causing them to rupture and giving rise to an emergency situation. Laparoscopically, these tubal pregnancies can be removed and the patient can be saved, provided the patient report to us early.
Laproscopic Tubal Recanalisation (Tuboplasty):
For women who have already undergone permanent sterilization by cutting the tubes, Laparoscopic Tubal Recanalisation (Tuboplasty) can be done by joining the tubes back and the woman can still achieve pregnancy. However, one has to bear in mind that a small percentage of women develop ectopic pregnancy after Tuboplasty.
Laparoscopic Pelvic Floor Repair:
Women who have a weak Pelvic Floor or who develop vault prolapse after open Hysterectomy, can now be treated laparoscopically by placing a mesh and by fixing the vault to the sacral promontory (Sacrocolpopexy) or to the pectineal ligament (Pectopexy).
