If anatomical problems interfere with your ability to conceive or maintain a pregnancy, infertility surgery may be recommended. Common indications for surgery include the following:
- Blocked fallopian tubes
- Polycystic ovary syndrome (PCOS)
- Adhesions (scar tissue).
- Reversals of sterilization procedures for men and women
Common surgical procedures to diagnose and treat infertility include:
- Operative hysteroscopy
- Diagnostic and operative laparoscopy
- Open abdominal procedures: Although most infertility surgeries are performed using the minimally invasive techniques, sometimes laparoscopy or hysteroscopy will not be sufficient to correct an abnormality of the pelvis.
In this section, we review surgery options for specific fertility problems.
The only sure way to diagnose endometriosis is with surgery such as laparoscopy. The surgeon may use either laparoscopy (outpatient surgery) or a laparotomy, which requires an abdominal incision and hospitalization. Both laparoscopy and laparotomy can help diagnose endometriosis and remove abnormal tissue and adhesions. Oftentimes, laparoscopy and laparotomy will help a woman conceive on her own without requiring additional fertility treatments.
When fertility problems affect the uterus, surgery can help to restore your fertility. Uterine surgery can correct blockages and abnormal tissue growth and remove scar tissue and fibroids. Surgery can also help repair an abnormally shaped uterus. A surgery called hysteroscopy may help, reducing miscarriage rates and leading to a healthy pregnancy.
PCOS and ovarian drilling
Polycystic ovary syndrome (PCOS) can cause your body to produce too much testosterone and insulin, leading to fertility problems. If you have PCOS, your ovaries may have a thick outer surface, which can affect your ability to get pregnant. High testosterone levels can cause irregular menstrual cycles, prevent ovulation and hinder pregnancy.
PCOS treatments, including ovarian drilling, could help you conceive by regulating your hormone levels and improving your ovulation and menstrual cycles. After ovarian drilling, testosterone production decreases and many women ovulate more regularly. By regulating your cycles for several months or more, ovarian drilling may offer you a window of opportunity to become pregnant that you did not have before.
Some men and women choose surgical sterilization when family building is complete. Many women opt for tubal ligation, also called tying the tubes. Men often choose vasectomy. A woman may choose to have her tubal ligation reversed while a man may choose vasectomy reversal. These reversals offer many individuals another chance to become parents.
With any surgery, there are always complications to consider, along with recovery time. Your doctor will discuss the risks of surgery for infertility with you, as well as the benefits. Together, you and your doctor can decide what’s best for your situation—so you have an increased chance of getting pregnant going forward.