Following your initial testing and assessment, you may need to have surgery. This could be to further investigate the cause of infertility for you or your partner, or to overcome the problems making it difficult for you to conceive.
Female fertility surgery
Diagnostic laparoscopy and hysteroscopy
This test is an important step in evaluating your fertility evaluation, but as it is quite invasive it is usually one of the last tests done.
If your history or other tests show an obvious need for IVF, we may not need to carry out the laparoscopy.
For a laparoscopy, you will be under general anaesthetic. Small incisions are made at the navel and the pubic hairline, and a laparoscope (a fibreoptic telescope) is passed through the incision so we can check your ovaries, fallopian tubes, uterus and pelvic cavity for abnormalities. We also check your tubes are open (tubal patency) by injecting dye through the uterus and observing it spill through the ends of the fallopian tubes.
Hysteroscopy uses another fibreoptic device, called a hysteroscope. This helps us see into the uterine cavity to check for growths, adhesions and abnormal anatomy.
Treatment for endometriosis
If your fertility specialist suspects you to have endometriosis, they may recommend a laparoscopy to confirm this diagnosis. Treatment options depend on how serious this disease is. We might remove the endometriosis and associated scar tissue at the time of the 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.
Several of our fertility specialists have an interest in the treatment of endometriosis, including advanced laparoscopic skills for removing the disease.
Surgery for fallopian tubes
If you have any damage to your tubes, we will usually diagnose this during a laparoscopy. If it is likely to affect the success of your IVF, your doctor may recommend tubal surgery before starting treatment.
In some cases, your doctor may recommend surgery to remove scar tissue or to correct tubal damage. Some types of tubal surgery may be performed through the laparoscope, while other procedures (such as tubal surgery) may require microsurgery (see below).
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 will be the treatment option with the best chance of success.
Microsurgery procedures include reversing sterilization, re-opening of blocked tubes and removing scar tissue around the uterus, tubes and ovaries.
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.
Male fertility surgery
Male microsurgery also involves specialised operative techniques for the repair of very small structures, such as the tubes that carry sperm (the vas deferens). These procedures include reversing a vasectomy and sperm retrieval procedures.
Learn more about infertility
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