Healthy Living

Laparoscopy and Infertility

Laparoscopy and Infertility

Key Takeaways

  • A laparoscopy is a surgical procedure, which allows your fertility doctor to examine your abdominal organs.
  • Laparoscopy is widely used as it is a less invasive procedure as compared to an open surgery. 
  • A laparoscopy can be used as a diagnostic test for the identification of infertility problems.

Laparoscopy

A laparoscopy is a surgical procedure, which allows your fertility doctor to examine your abdominal organs. In females, their fallopian tubes, uterus, and ovaries are found in the pelvis region, which is at the bottom of the abdomen. The procedure uses a laparoscope to visualize the abdominal organs. The instrument is a long thin tube that has a front camera. The front camera transmits the images captured onto an adjacent screen, which enables your fertility doctor to observe your organs in real time. A laparoscopy can be used as a diagnostic test for the identification of infertility problems.

Why is the procedure used in women with infertility problems?

Various gynecological defects such as fibroid tumors, scar tissues, and endometriosis can be readily examined through a laparoscopy. Furthermore, uterine, tubal, and ovarian abnormalities can be identified using this procedure. Most of these abnormalities usually interfere with a woman’s ability to conceive.

Laparoscopy is widely used as it is a less invasive procedure as compared to an open surgery. You are also likely to get minimum scars after a laparoscopy. In an open surgery, large incisions are made, thereby creating more significant and visible scars.

Why is laparoscopy for infertility recommended for you?

Often, your medical records and physical examinations generally don’t give a clue about your infertility problems. Therefore, when you visit an infertility clinic, the answers to the underlying cause of your infertility problem will be minimal or none. In this type of situation, you are advised to give your pelvis some time and postpone any surgical investigations intended for the pelvis. However, studies from your medical records and examinations may sometimes indicate why an infertility problem is present. Some examples of infertility problems are:

  • On tests, your periods are found to be continuously heavy, and the uterus is massively enlarged with fibroids.
  • If you had previously stated that you experience pain during sexual intercourse, thereby making it uncomfortable. The examinations might show that a full penetration has never actually occurred and that your vagina is tight.
  • When your periods and sexual intercourse are painful, especially during deep penetration. Examinations might reveal an endometriosis, where the tissues lining the uterus grow outside of it.
  • Your prior pregnancies with your spouse are frequently terminated, which signals infertility. When there is a failure to achieve pregnancy, blocked fallopian tubes due to an infection might be the primary cause.
  • When you have a history of a pelvic surgery that might indicate adhesions leading to infertility problems.

Which type of infertile patients should undergo this operation?

In most cases, a laparoscopy is reserved for partners who have gone through a basic infertility examination, which may include the ovarian reserve, ovulation assessment, ultrasound, and hysterosalpingogram (an X-ray of the fallopian tubes and uterus).

How is the surgery performed?

The operation generally takes about two hours of your time, depending on which technique is employed and the corrective work that is required. A case that is complicated in nature will take up to four hours or even more.

The following are the steps during a laparoscopy:

  • Step 1. After administering the general anesthesia, your doctor makes small cuts or incisions beneath the navel.
  • Step 2. The laparoscope (a telescope for viewing abdominal organs) is inserted through the cuts allowing the surgeon to observe the affected areas.
  • Step 3. After identifying the problem, the cuts are stitched back.

Hospital Discharge and Recovery

The patient is usually released from the hospital two hours after completion of the operation. You will then require an extra two days off from your work after the procedure. Mild pain is to expected and may last for up to seven days. Therefore, get the right pain-relieving drug prescription from your doctor. Moreover, get prescriptions for drugs that relieve nausea. The drugs that will be used for the pain will always be on the need list, while those for nausea may or may not be indicated.

The actual length of time to achieve a full recovery will always depend on the type of operation that was carried out, how long the operation took, and the number of cuts or incisions that were made. Your recovery also depends on whether you had a previous surgery, your current health condition, and how tolerant you are toward the surgery.

You are allowed to eat and drink whatever you wish if the laparoscopy operation is successful and no complications arise whatsoever. You will need to rest to allow the general anesthesia to wear off. You will likely to experience drowsiness from the anesthesia. A 24-hour rest is highly recommended. Normal activities can then be resumed if you feel well enough. But depending on the procedure performed, some women take weeks to resume their normal activities, while others will only require a few days.

What are some of the complications resulting from a laparoscopy?

The potential risks may include possible injuries to other pelvic organs such as the ureter, bowels, blood vessels, and the bladder. When injuries occur, open surgery is recommended. However, the risks are generally uncommon.

Anesthesia-related complications can also be experienced. Furthermore, infections that are post-operative such as surgical wound infections and bleeding can also occur. 

These risks are generally the same with other types of operations. However, all of the above complications are unusual when the laparoscopy procedure is done with expertise on healthy women.

Are there any other alternatives for treating infertility in women besides laparoscopy?

IVF (in vitro fertilization)

The two most commonly encountered risks during a laparoscopy are adhesion and endometriosis. These problems can be treated using IVF since IVF is even less invasive as compared to a laparoscopy and its success rates are usually high. Therefore, some couples may prefer to go directly to IVF. If the patient has an adhesion problem, it will not affect her chances of conceiving through IVF.

Hysteroscopy

Hysteroscopy is a procedure that is used to examine the uterine cavity for any adhesions, fibroids, or septum development (a wall that divides the cavity of the uterus); all of which may hinder a woman's ability to conceive.

Pelvic Examinations

An internal pelvic examination is carried out to check the cortex and the vagina, and to analyze the size, position, mobility, and the shape of your ovaries and uterus.

Other alternative treatments for infertility can also include fertility treatments such as superovulation and intrauterine insemination.

Further Operations

Your doctor might advise you to get further surgery when there is a blockage in your fallopian tubes, a polycystic ovary syndrome (PCOS) that does not respond to drugs, or if you wish to have a reversal procedure. Other surgeries may also be done when fibroids, endometriosis, or any other conditions significantly affect a pregnancy implantation.

It is advisable that you visit your doctor if you feel like you have any issues that need to be examined through laparoscopy.