Finding it difficult to conceive? Chances are, you may have fertility problems. However, the good news is that numerous medical options are available to help you get pregnant. Several factors affect fertility, so it is best to consult with a fertility specialist who will help you diagnose the cause of infertility and suggest possible treatments.
Apart from general fertility examinations and tests, the specialist may also recommend ultrasound, sono-hysterogram or hysterosalpingogram (x-rays). If these fail to determine the cause, the fertility specialist may suggest Laparoscopy or Hysteroscopy. Studies have shown an increase in chances of pregnancy after hysteroscopy and laparoscopy procedures.
1. Causes of Infertility in Women
Endometriosis is a painful reproductive disorder that occurs when there is an abnormal growth of endometrial-like tissues/cells outside the uterus or on other organs inside the body, typically on the intestine, ovaries, fallopian tube and the pelvis area.
Endometriosis can cause pelvic pain during menstruation resulting in sub-fertility. Some of the symptoms of endometriosis include painful & heavy periods, lower abdominal and pelvic pain, pain during sexual intercourse and painful bowel movements.
- Uterine Fibroids:
Uterine fibroids are non-cancerous growth that develops in the uterus. Out of the three types of fibroids, the submucosal fibroids that grow inside the uterine lining are likely to cause infertility. Recurrent miscarriage is also one of the symptoms of uterine fibroids.
- Pelvic Inflammatory Disease:
Pelvic inflammatory disease (PID) occurs when bacteria, such as chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG), move upward from the vagina or cervix into the reproductive organs. The signs and symptoms of PID can be mild, with some women not even realising it until they experience trouble getting pregnant or develop chronic pelvic pain. If not treated, PID can permanently damage the female’s reproductive organs.
- Congenital Uterine Abnormalities:
Congenital uterine anomalies are malformations of the uterus. The statistics of women experiencing this is quite low – less than 5%. But, it has been seen in up to 25% of women who’ve delivered premature babies or had miscarriages.
To learn more about the causes of infertility, check our blog!
2. How Can Laparoscopy Help You Conceive?
As mentioned above, there are high chances of getting pregnant after the laparoscopy procedure. It is a safe option to consider if you are experiencing trouble conceiving. Based on the diagnosis, during the procedure, the healthcare specialist may:
- Repair the hydrosalpinx
- Remove fibroids
- Unblock the fallopian tube
- Reverse a tubal ligation.
2.1 When is Laparoscopy Used?
Laparoscopy for infertility is only performed if other fertility treatment options don’t help. For this reason, laparoscopy is often performed only on women with unexplained infertility. It allows for biopsy of suspect growths and cysts that can hamper fertility. It is also recommended for women who experience pelvic pain, a symptom of endometriosis.
2.2 How is Laparoscopy Performed?
- Laparoscopy for infertility involves two incisions – one at the navel and the other at the pubic hairline.
- A laparoscope – a fibre-optic tube with a light and a video camera – is inserted into the opening, followed by surgical tools.
- The procedure is performed under general or local anaesthesia and usually takes 30-40 minutes.
- The abdomen is inflated with carbon dioxide or nitrous oxide to move the organs away from the abdomen.
- Once the abdomen is inflated, the laparoscope is inserted through the incision.
By viewing the interiors of the pelvic cavity on a video screen, the healthcare specialist can look for the possible cause of infertility. These causes could be:
- Abnormalities of the ovaries and uterus
- Blocked fallopian tubes
- Scar tissues
In an operative laparoscopy, to treat an identified condition, small surgical instruments are controlled through the laparoscope or the other small incision point.
- Fibroids, adhesions or endometrial tissues outside the uterus are removed with a laser beam or electric current.
- Once the surgery is completed, the incisions are closed with a couple of stitches.
2.3 Benefits of Laparoscopy
Some of the benefits of laparoscopy are:
- It helps determine the causes of infertility
- It is less invasive compared to open surgery. In other words, less pain, less blood loss, smaller incisions and faster recovery.
- It provides the specialist with a detailed look inside the abdominal region, which helps identify issues.
- It is effective in treating some of the causes of infertility, which helps boost your chances of getting pregnant after laparoscopy.
- It helps eliminate pelvic pain and discomfort
- It aids in removing adhesions, endometrial deposits and fibroids.
3. How Can Hysteroscopy Help You Conceive?
Hysteroscopy is a medical procedure that allows the healthcare specialist to examine the inside of the uterus to diagnose and treat certain gynaecological conditions. Operative hysteroscopy can be used to remove adhesions, fibroids and polyps. Treating these conditions can increase your chances of conceiving after hysteroscopy.
3.1 When is Hysteroscopy Used?
Reasons to have a hysteroscopy are to determine:
Some of the other reasons to use hysteroscopy are:
- To scan and remove polyps or fibroids
- Identify and remove displaced intrauterine devices (IUDs)
- To get a small tissue sample for biopsy or remove the endometrial lining.
The specialist may recommend scheduling the hysteroscopy procedure for the first-week post your menstrual period. This is the best time as it provides the specialist with the best view of the inside of the uterus.
3.2 How is Hysteroscopy Performed?
The procedure can be performed either in a doctor’s clinic or a hospital. The patient is provided with medication to help relax. Local or general anaesthesia may be used. Above all, there are no incisions made in hysteroscopy.
- The surgeon uses medication or dilators to stretch the cervix canal before gently passing the hysteroscope through the vagina, cervix and into the uterus.
- A fluid solution or carbon dioxide is used to expand the uterus, providing the surgeon with an excellent view of the uterine lining & cavity and the ends of the fallopian tubes.
- After a thorough visual examination, the surgeon may take a sample for biopsy or perform surgery to treat the condition, such as removing a uterine fibroid that may be causing infertility.
In an operative hysteroscopy, the surgeon uses special operating instruments that are passed through the hysteroscope tube to conduct the surgery.
Post the operative hysteroscopy:
- The patient can receive antibiotics to prevent infection and promote proper healing of the uterine lining.
- It is normal for women to experience small amounts of vaginal bleeding after the procedure, and they are allowed to go home within 1-4 hours post the procedure.
- In cases where general anaesthesia is utilised, the patient needs to wait until the anaesthesia wears off.
3.3 Benefits of Hysteroscopy
Hysteroscopy provides the following advantages:
- Shorter hospital stay and faster recovery
- Less pain medication post-surgery
- Avoidance of hysterectomy
- Possible avoidance of open abdominal surgery
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