Laparoscopy & Hysteroscopy
Fertility Enhancing Hysteroscopy Surgeries Hysteroscopy overview
- Diagnostic hysteroscopy uses a thin lighted tube (hysteroscope) to examine the cervix and inside a woman’s uterus to evaluate for problems.
- Operative hysteroscopy utilizes small tools to surgically correct a condition detected in the diagnostic hysteroscopy.
- Hysteroscopy reveals the size, shape, and lining of the uterus and any associated abnormalities that may affect female fertility.
- Operative hysteroscopy can remove uterine fibroids and polyps, open blocked fallopian tubes, and perform endometrial ablation if endometriosis is present.
What are diagnostic hysteroscopy & operative hysteroscopy?
Diagnostic hysteroscopy allows the physician to check the size, shape, and lining of a woman’s uterus to diagnose any abnormalities that may be affecting fertility or causing other gynecologic disorders.
With the patient under anesthesia, a thin viewing tool called a hysteroscope is inserted into the vagina and gently moved through the cervix into the uterus, where a liquid solution or carbon dioxide is inserted through the hysteroscope to expand the uterus. Once the uterus is expanded, light and camera on the hysteroscope allow the doctor to see the endometrium (lining of the uterus), ovaries, and fallopian tubes on a video screen.
Operative hysteroscopy may be performed to correct an abnormal condition found during diagnostic hysteroscopy. Small instruments can be inserted through the hysteroscope to correct problems such as endometriosis, uterine polyps and fibroids, or adhesions.
Hysteroscopy is typically an outpatient procedure. If a doctor has any concerns, such as a patient’s reaction to anesthesia, an overnight hospital stay may be required.
When is hysteroscopy performed?
Diagnostic hysteroscopy is used to identify problems in a woman’s uterus that may be contributing to infertility. The procedure may be performed to:
- Determine whether the uterus is abnormally shaped or contains scar tissue
- Find potential causes of recurrent miscarriages
- See blocked fallopian tubes
- Find fibroids and polyps
- Determine causes of abnormal bleeding and severe cramping.
Operative hysteroscopy is used to correct abnormal conditions that are determined during diagnostic hysteroscopy. Hysteroscopes may be used to insert small tools into the uterus to:
- Remove uterine fibroids and polyps
- Unblock fallopian tubes
- Remove the endometrium using a heated tool if endometriosis is present. Endometrial ablation is not performed in women who wish to become pregnant, as it destroys much of the lining of the uterus.
Laparoscopy, another minimally invasive surgical procedure, may also be performed at the same time as a hysteroscopy to determine the causes of infertility.
Fertility Enhancing Laparoscopic Surgeries
- Laparoscopy for infertility is a minimally invasive surgical procedure in which a telescope-like instrument (laparoscope) with light and a small camera allow the surgeon to examine the pelvic anatomy for causes of female infertility.
- Laparoscopy can be diagnostic, assessing for causes of infertility in the uterus, fallopian tubes, and ovaries.
- An operative laparoscopy involves surgical treatment for problems found during a diagnostic laparoscopy procedure, utilizing small surgical tools passed through the laparoscope.
- Laparoscopic surgery can also be used to remove scar tissue or endometriosis.
What is laparoscopy for infertility?
Laparoscopy for infertility is a minimally invasive surgical procedure that uses a laparoscope (a fiber-optic tube with light and video camera) inserted through two or more minor incisions, often in the belly button. The surgeon can then visually examine the pelvic reproductive organs and the pelvic cavity.
The procedure may be performed under general anesthesia or local anesthetic and typically takes 30 to 45 minutes. The abdomen is inflated with gas (carbon dioxide or nitrous oxide injected with a needle) to move the organs away from the abdominal wall so that they are visible during the procedure.
Once the abdomen is inflated, the laparoscope is inserted through the small incisions. The surgeon views the interior of the pelvic cavity on a video screen transmitting the images from the camera.
The surgeon will look for possible causes of infertility. These could be:
- Abnormalities of the uterus and ovaries
- Blocked fallopian tubes
- Scar tissue
- Fibroid tumors
- Endometriosis (which can only be confirmed via laparoscopy).
The surgeon may decide to correct the problems detected. This becomes an operative laparoscopy, and small surgical instruments are manipulated through the laparoscope or another small incision point. The surgeon can remove scar tissue, fibroids, or endometrial tissue that has incorrectly implanted outside the uterus. The surgeon cuts tissue or removes it with a laser beam or electric current (electrocautery).
The surgeon closes the incision in the abdomen with a few stitches. There is usually little or no scarring.
When is laparoscopy used for treating infertility?
Laparoscopy for infertility is generally only performed after other fertility tests have not resulted in a conclusive diagnosis. For this reason, laparoscopy is often performed on women with unexplained infertility.
Laparoscopy also allows for biopsy of suspect growths and cysts that may be hampering fertility. Laparoscopy may be recommended for women experiencing pelvic pain, which is a potential symptom of endometriosis. Laparoscopy can also remove scar tissue that can be a cause of pelvic or abdominal pain.