The laparoscopy procedure is a keyhole surgery that provides a panoramic and magnified view of the pelvic organs. This medical procedure does not involve many risks and requires only a small incision. Laparoscopy for infertility procedure allows surgery at the time of diagnosis itself.
In this blog post by Dr Manish Banker, we’ll look into how laparoscopy for infertility is beneficial and the other numerous problems it can treat.
Laparoscopy is the only way to diagnose some causes of infertility. Your doctor can use laparoscopy to not only examine what’s going on within your abdomen but also to biopsy any abnormal growths or cysts. Laparoscopy for infertility is usually performed, only after other fertility testing methods have failed to provide a definite diagnosis or as an initial test if some specific causes are suspected. As a result, laparoscopy is frequently used to treat women experiencing infertility for no apparent cause. Laparoscopy for infertility also enables the biopsy of suspicious growths and cysts that may be interfering with fertility.
After the anaesthetists have given general anaesthesia, the laparoscopic surgeon makes a tiny cut of roughly 1-1.5 cm around the belly button. After that, surgeons place a tube into the incision and pump gas into the abdomen through it. A laparoscope is then inserted through this tube. The tube relays the image to a television monitor in the operating theatre, giving the surgeon a clear view of the whole area. A further incision can be made if surgical treatment is required. The incision is closed with stitches or clips, and a dressing can be applied. In a laparoscopy procedure, the surgeon can also collect biopsy samples.
Endoscopic reproductive surgery intended to improve fertility may include surgery on the uterus, ovaries, pelvic peritoneum [fatty curtain over the pelvic organ], and fallopian tubes.
There are various reasons why a laparoscopy procedure is done. Here are some of the reasons:
Tubal Patency- A laparoscopic surgeon performs this procedure to check tubal patency to get a good fertility outcome.
Adhesions– For infertile couples with pelvic adhesions, laparoscopic surgery is a helpful and effective treatment. Adhesion surrounding pelvic organs may have detrimental effects on fertility outcomes. So, by performing laparoscopic procedures, you can have it removed. And this will also increase the fertility outcome.
Laparoscopic Myomectomy– Fibroids are the most prevalent tumours of the female reproductive system, affecting 30-40% of women of their reproductive age. Myomectomy for submucosal fibroids results in higher pregnancy rates. The removal of intramural/ subserosal fibroids shows a beneficial trend in increasing the chances of pregnancy. Laparoscopy has a notable benefit over laparotomy, which is another popular treatment since it significantly reduces adhesion development.
Endometriosis– For moderate to severe endometriosis, surgery will improve the chances of pregnancy after a laparoscopy. Large endometriomas may need to be removed surgically before IVF, but smaller ones are generally best left in place. Surgery for very severe endometriosis or repeat surgery is generally not beneficial and may cause harm by reducing ovarian reserve, and these patients better respond to ART.
Hydrosalpinx– Hydrosalpinx is a chronic pathological condition of the fallopian tube, and it is one of the major causes of infertility. In most patients, the fallopian tubes are bloated with fluid. At the same time, laparoscopy surgery gives both a specific diagnosis and treatment for hydrosalpinx. A positive impact on pregnancy rates is noticed in patients after laparoscopy.
Laparoscopic Tuboplasty– Tuboplasty, or laparoscopic tuboplasty, is a highly effective procedure for repairing damaged tubes. Laparoscopy has a high success rate when the patient is young and has adequate ovarian function and tubal health. An overall 50% success rate is claimed for this procedure. In the case of tube blockage, we can use an additional method called hysteroscopic cannulation to remove the block.
Cystectomy- Laparoscopy surgery for benign ovarian tumours is associated with improved fertility outcomes.
Additionally, a laparoscopic surgeon can also do hysteroscopic guided biopsies and therapeutic treatments such as polypectomy, septal resection, and adhesiolysis in the same session.
Laparoscopy’s success rate in treating infertility with tubal repair varies significantly. If you’re considering IVF following a laparoscopy, your doctor may advise you to forego the operation and go straight to IVF.
To conclude, endoscopic surgery fulfils the vital principle of gentle handling of tissue. The procedure is recommended as the dissection of the skin is precise, leading to a very minimal skin incision and tissue handling is very accurate leading to minimal damage to the normal tissues. There are several reasons why laparoscopy procedures are performed, including laparoscopy for infertility. However, these are the main reasons. If you have any of these issues, consult a fertility specialist such as Dr Manish Banker, and understand all of your options.
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