Laparoscopic Myomectomy – Fertility Enhancing Surgeries

Laparoscopic Myomectomy :

Laparoscopic myomectomy is a surgical procedure for women with uterine (womb) fibroids. Fibroids are the most common tumours in the female. Fibroids in infertile women undergoing assisted reproductive treatment can decrease success rates in comparison to age-matched women with no fibroid. You can choose for removal of fibroids (laparoscopic myomectomy) before fertility treatment. Your doctor will advise laparoscopic myomectomy if you have unexplained infertility. If you have fibroids growing into the uterine cavity then you are more likely to benefit after myomectomy. You can achieve pregnancy after laparoscopic removal of fibroids. So this procedure can be considered if you are suffering from infertility for long years.

Surgeries that can enhance fertility

Fertility enhancing procedures like laparoscopic myomectomy are usually advised to young women. Your doctor may suggest these procedures before IUI or IVF treatment. These surgeries enhance the rate of natural pregnancy or IUI treatment. Usually such surgeries are done by experts through laparoscope to prevent damage to pelvic organs.

Tubal anastomosis:

Approximately 1% of the women who undergo tubal sterilization procedure may request reversal of the procedure to restore fertility. If you are going for this procedure you must be aware of its cost and benefit. Often your doctor will advise IVF treatment as a better alternative. Tubal anastomosis by the laparoscopic approach has the advantages over open surgery. Laparoscopy surgery has less postoperative discomfort and fewer complications. It has a smaller incisional scar, a shorter recovery time. You can start working laparoscopic procedure. Laparoscopy avoids a big scar. This is beneficial for a patient who previously has undergone a open surgery.

Fertility specialist knows the best time to suggest for surgery. Not all patients will require procedures. Selection and surgical technique are key factors in achieving satisfactory pregnancy rates.

Excision of endometriosis:

If you have moderate endometriosis, your doctor will advise surgical removal or heat destruction(ablation). At first your doctor will try medical treatment in endometriosis. This may give you with higher success rate.

Laparoscopic surgery for destruction of mild endometriosis almost doubles the spontaneous pregnancy rate. IVF is the best option for patients after failed primary surgery. Just try to avoid a repeat surgery. This is associated with lower pregnancy rate.

The pregnancy rate after intrauterine insemination IUI increases after surgery for mild endometriosis. IUI can not offer success in patients with moderate or severe endometriosis and in older women. IVF Treatment doesn’t increase incidence of recurrence of endometriosis.

Ovarian cystectomy:

Ovarian cysts commonly are simple cysts(functional)or chocolate cysts (endometrioma).

Functional cysts, unless they become very large, these types of ovarian cysts don’t affect fertility. Hence your doctor may prefer to wait and watch for growth of these cysts. Small cysts may regress on their own.

Laparoscopic surgery like cyst aspiration or excision.will cure ovarian endometriomas.

Distal tubal disease and tubal reconstruction:

These procedures are of minimal benefit for fertility. If you are young and want to avoid IVF your doctor will advise removal of diseased tubes.. Of all surgical treatments for tubal disease, sterilization reversal results in the highest pregnancy rates. The procedure is appealing to couples who desire an extended family or who are not comfortable with IVF. You may have risk of ectopic pregnancy after this procedure.

Adhesiolysis :

Laparoscopic adhesiolysis still remains a useful and effective procedure for infertile couples with pelvic adhesions. These adhesions may be a result of previous surgery or infections like abdominal tuberculosis.

Septal resection:

Although septate uterus does not seem to be an infertility factor hysteroscopic septum resection is accompanied by a significant improvement in the reproductive performance. There is no adverse effect in the achievement of pregnancy in women with a history of recurrent abortions after septum removal.

Metroplasty:

Metroplasty refers to repairing the womb with birth defects like extra horn, double uterus or divided uterus. Women with uterine partition(septum) and otherwise unexplained infertility might benefit from hysteroscopic metroplasty.

Ovarian drilling:

PCOS women often undergo Ovarian drilling. It is done to break the thick outer surface and so destroy some of the testosterone producing tissue made by the ovaries. This can help the ovaries release an egg each month and start regular monthly menstrual cycles. This may reduce symptoms of excess testosterone as well.

Uterine transplantation:

It is an advanced surgical procedure introduced recently. If you don’t have a uterus by birth, uterine transplant may help you. Although it appears as a breakthrough procedure in the field of infertility its results are yet to be studied. You can get a healthy uterus from another woman in this procedure.

Surgery for Ectopic pregnancy:

Surgery for ectopic pregnancy usually involves the fallopian tubes. Your doctor will try to save the fallopian tube for future fertility. But recurrence of ectopic is common in such situations.

Fertility enhancing surgery in male infertility

Varicocelectomy:

Varicocele is one among the most common causes of male infertility. Increased temperature reduces sperm production. The results of varicocele surgery are not conclusive and not encouraging for restoring fertility. This is reserved for people with severe grade of the disease. ICSI is an alternative method of fertility treatment in these patients.

TESA, PESA, MESA & Testicularbiopsy:

These are procedures of sperm retrieval for patients undergoing ICSI treatment. If you have blockage of vas deference this surgery will benefit you.

Reversal of vasectomy:

Vasectomy reversal is surgery to undo a vasectomy. Success rates with vasectomy reversal will range from about 40 percent to over 90 percent. In some cases, pregnancy may not happen after a vasectomy reversal, even when there is sperm. This is due to decreased motility of sperm.

Benefits of bariatric surgery for obesity in male and female:

Obese men and women may benefit from weight loss programme or surgical removal of fat content from body.

Female Infertility

Polycystic ovary syndrome (PCOS) is the most frequent cause of female infertility. If you have PCOS, hirsutism, and menstrual irregularities then it may improve after bariatric surgery. The increased risk of miscarriage in obese women may decline after bariatric surgery.

Male infertility 

Obesity causes disturbances in hormone production and leads to reduced sperm concentrations. Weight loss is the cornerstone of the treatment of obesity-related infertility. It can restore fertility and normal hormonal profiles. But effects of bariatric surgery impact on male fertility is still unclear. Sperm count may go down after obesity surgery at times.