Laparoscopy for infertility treatment is a surgical procedure applied for the diagnosis and surgical treatment of the followings:
• Detection and removal of fibroids
• Draining of endometriosis accumulation
• Pelvic pain
• Ovarian cysts, and
• Blocked fallopian tubes
This surgical procedure allows a direct view and access to the uterus, ovaries, tubes, other female reproductive organs, and the entire pelvic cavity.
Laparoscopy is not always the first test prescribed to the couples for diagnostic evaluation, due to its cost and invasive nature. Generally, the following medical tests are assessed before considering a laparoscopy. These are:
• Semen analysis
• Assessment of ovarian reserve
• Hysterosalpingogram, and
• Tracking and documenting evidence of ovulation
However, if the woman has an obvious and evident ovulation problem or her partner has clear sperm abnormalities such as, low sperm count or lesser sperm mobility or morphology, then it is doubtful to prescribe laparoscopy as it will not provide any additional information that may be useful for them to conceive.
Why is laparoscopy applied in women affected with infertility?
The laparoscopy procedure allows the doctor to determine the occurrence of defects such as:
• Scar tissue
• Presence of fibroids
• Abnormalities of the Uterus
• Deformity of Fallopian Tubes And
• Flaws in Ovaries
Laparoscopy, until the mid-1990s, was known to be a part of the standard female infertility workup. Before 90’s Reproductive Endocrinology and Infertility specialists executed laparoscopy before applying gonadotropins for ovary superovulation as a part of the fertility treatment. This traditional treatment has questionable benefits in context to its cost-effectiveness and invasiveness.
After major advances in the field of IVF and IVF technologies with the use of laparoscopy, couples are more fascinated towards it due to the notable success rate. They ask for insemination treatments and in vitro fertilization through laparoscopy for better and faster results.
Advantages of Laparoscopy for Infertility
Laparoscopy allows the diagnosis of every minor details of infertility problems that otherwise would not have been possible. For example, severe endometriosis can be located and identified by using ultrasound. However, the presence of mild endometriosis can only be ascertained and established by using laparoscopy surgery.
Laparoscopy for Infertility
Pelvic adhesions are another problem that can only be diagnosed in a person through laparoscopy surgery. It is also known as scar tissue and the adhesions cannot be viewed under ultrasound, CT scans, or x-rays. Adhesions disturbability to conceive and make it difficult for the egg to enter the fallopian tube for ovulation.
Laparoscopy is a less invasive surgery to treat infertility than that of traditional surgery. It requires making an incision in the abdomen in Traditional surgery that can be several centimeters long. Hence, the patient remains two to three nights in the clinic or hospital. On the other hand, Laparoscopy uses one to three very minor incisions of half a centimeter to one centimeter each in length.
Infertile Patients Going For Laparoscopy
Usually, laparoscopy is executed on couples who have undergone basic infertility evaluations like, assessing for ovulation, ultrasound, hysterosalpingogram, semen analysis and assessment of ovarian reserve. Some couples, however, skip laparoscopy and proceed for other fertility treatments like superovulation with fertility medications in combination with In Vitro Fertilization (IVF) or intrauterine insemination.
Possible reasons why the doctor may recommend diagnostic laparoscopy:
1. In case the female experiences mild to severe pain during sexual intercourse
2. If the female suffers from severe menstrual cramps every month or pelvic pain that may occur at other times of her menstrual cycle
3. Moderate to extreme suspected endometriosis
4. Suspected severe pelvic adhesions or pelvic inflammatory diseases
5. If the doctor suspects an ectopic pregnancy that might turn out to be life-threatening for the mother, if left untreated
Recommendation of Laparoscopy during Fertility Treatment
1. Laparoscopy determines and repairs the infertility issues of female reproductive organs at the same time. It right away removes the causes of infertility at the time of diagnosis only.
2. Laparoscopic surgery is used to surgically treat causes of female infertility. The doctor may recommend laparoscopy surgery if he suspects Hydrosalpinx, which is a particular type of blocked fallopian tube. Improved IVF success rates are achieved once the affected tube is removed.
3. Endometrial deposits reduce fertility in a woman. It sometimes also causes unbearable pain in the pelvic region. Removal of such deposits reduces the pain and improves pregnancy success rates. Endometrial deposits should be removed even if they are causing no pelvic pain.
4. Laparoscopy surgery unblocks and repairs the fallopian tube. The success rates of a healthy pregnancy are increased when it is achieved after tubal repair. For a young woman, surgical repair of fallopian tubes should be executed first if her other fertility factors look good. This removes possibilities of pregnancy infection and keeps the baby safe in the womb.
5. Ovarian cysts also cause abdominal pain or blockage in the fallopian tubes. Small ovarian cysts can be drained with an ultrasound-guided needle. However, removal of large endometrial ovarian cysts is required to reduce the ovarian reserve. Doctors usually prescribe laparoscopic surgery to locate the bigger ovarian cysts and remove them.
6. The presence of fibroid in the reproductive organs often causes pain. It distorts the uterine cavity and blocks the fallopian tubes. Laparoscopy surgery removes the fibroids soon after its detection and assures a healthy womb for the baby to develop.
7. The doctor recommends ovarian drilling in the case of Polycystic Ovary Syndrome (PCOS). Laparoscopic ovarian drilling includes creating tiny punctures into the ovaries. This laparoscopic drilling procedure enables women with PCOS prior to using ovulatory drugs to ovulate on their own.
Importance of Laparoscopy in Infertility
There are a few causes of infertility that can only be diagnosed by laparoscopy. Endometriosis is one such major cause. Laparoscopy allows the doctor to access the reproductive organs of the abdomen and perform biopsy to detect the presence of any suspicious growths or cysts.
Apart from that, laparoscopic surgery treats causes of infertility and allows the female a better chance of conceiving either naturally or with various fertility treatments.
However, the most important cause for prescribing diagnostic laparoscopy is if the patient is experiencing pelvic pain.