Following your initial testing and assessment, your fertility specialist may recommend surgery. This could be to further investigate the cause of infertility, or to overcome the problems making it difficult for you to conceive.
Female fertility surgery
A laparoscopy is a keyhole surgery, and may be recommended to check your tubes are open (tubal patency) and the condition of your uterus and ovaries. It can also treat conditions such as
- tubal microsurgery
- removal of fibroids
- correction of uterine abnormalities.
A laparoscope is introduced through a small incision in the abdomen. A video camera is fitted to an endoscope (a thin telescopic instrument) so the specialist can view the images on a video monitor.
If any surgical treatment is needed, special instruments are inserted through four other small incisions, usually hidden in the pubic hair. When the surgery is complete, the instruments are removed and the carbon dioxide gas is released from the abdominal cavity. A stitch closes each of the small incisions.
Laparoscopy is performed under general anaesthetic and takes about one to two hours. Your recovery will depend on the amount of surgery you need, but we recommend you take one or two days off work following the procedure.
After your operation, you may experience some symptoms that may last for several days, including tiredness, muscle pain, mild nausea, pain or discomfort at the site of the incisions, cramps, a small amount of vaginal discharge or bleeding or a sensation of swelling in the abdomen.
Surgery for endometriosis
If your fertility specialist suspects you to have endometriosis, we may be able remove the endometriosis and associated scar tissue at the time of the diagnostic laparoscopy, or give you hormone treatment to suppress the menstrual cycle and inhibit the growth of endometriosis.
Sometimes this treatment for endometriosis will result in a successful pregnancy. If not, IVF may be a good treatment option.
Surgery for fallopian tubes
If you have any damage to your tubes, we can diagnose this during a laparoscopy. If it is likely to affect the success of your IVF, your doctor may recommend tubal surgery to remove scar tissue or to correct tubal damage before starting treatment.
Some types of tubal surgery may be performed through the laparoscope, while other procedures (such as tubal surgery) may require microsurgery.
If tubal surgery does not result in a successful pregnancy – or where damage to the tubes and other pelvic organs is so severe as to make surgery unlikely to be successful – IVF may give you the best chance of success.
Microsurgery involves specialised operative techniques, including the use of an operating microscope. Surgeons trained in microsurgery use these skills and techniques for the repair of very small structures or obstruction, in the fallopian tubes and removing scar tissue around the uterus, tubes and ovaries.
Male fertility surgery
Male microsurgery involves specialised operative techniques, including the use of an operating microscope for the repair of very small structures, such as the tubes that carry sperm (the vas deferens). It is commonly used where there is a low sperm count, or no sperm at all.
Microsurgery can be used to:
- reverse a Vasectomy
- bypass a blockage in the epididymis,
- cure a Varicocele (swelling of the veins about the testis), which allows the testis to produce better sperm,
- In the case of azoospermia (absence of sperm in the testes), microsurgery is also used to perform surgical sperm retrieval so it can be used for Intracytoplasmic Sperm Injection (ICSI). The genetic make up of the sperm is tested first, before fertility treatment.
Most microsurgery is done as a day surgery procedure, and you will need up to a week to recover after the procedure. Occasionally we can cure obstruction to sperm passage in the urinary tract.
Our surgeons also perform Vasectomy where indicated.
Watch video: Microsurgery
Want more information?
To find out more about the fertility surgery that could improve your chances of conceiving please come to a free information night or book an appointment with a fertility specialist. Appointments are available within the next couple of weeks and will cost approximately $150 for a couple after the Medicare rebate.