Treatments & Options - Surgery - Procedures

Infertility specialists are not only clinicians; they are also surgeons. Infertility surgical procedures can help to correct many fertility problems and anatomical abnormalities that may lead to infertility or pregnancy losses. Here, we list the most common types of surgical procedures performed by fertility specialists.

Hysteroscopy
During an operative hysteroscopy, under general anesthesia, a small hysteroscope (a fiber optic telescope) is inserted through the cervix and advanced into the uterine cavity. This procedure allows for direct views of the uterine cavity and permits the physician to surgically correct the abnormality. Patients go home the same day as the procedure and can often return to work the next day.

Laparoscopy
Laparoscopy, a minimally invasive surgery, often requires only a few 0.5 cm incisions through the abdominal wall. The surgeon inserts a laparoscope, a small fiber optic telescope, into the abdomen through these small incisions to view and make surgical corrections to the pelvic structures involved. Operations can take as little as 20 minutes to many hours, depending on the extent of the problem. Laparoscopy is a less-invasive procedure than open abdominal surgery and allows for a quicker recovery with a lower risk of adhesion (scar tissue) formation. Most patients go home the same day as the procedure and return to work 3 to 4 days later.

Open Abdominal Procedures
The most common type of abdominal procedure performed by infertility specialists is an abdominal myomectomy, the removal of large uterine fibroids. Most open abdominal procedures require at least 1 or 2 nights of hospitalization. Most patients return to work within 4 to 6 weeks

Ovarian drilling
Ovarian drilling is a laparoscopic procedure performed under general anesthesia. The surgery is typically done on an outpatient basis with minimal recovery time. Ovarian drilling is a surgical procedure that breaks through the ovary's thick outer layer, destroys small portions of it, boosting fertility.

Here is how ovarian drilling works:

  1. Your surgeon makes a small incision below your belly button.
  2. He or she inserts a tube into your abdomen, filling it with carbon dioxide. This inflates your abdomen and prevents damage to your internal organs.
  3. A thin telescope with a camera attached is inserted into your abdomen, allowing your surgeon to view your internal organs and ovaries. Guided by the camera, the surgeon inserts special tools and uses an electric current to make very small holes on your ovaries.

Reversals
Getting your tubes tied or undergoing a vasectomy is a permanent form of birth control but sometimes an individual chooses to reverse the procedure. Attain Fertility discusses surgical options for tubal reversal and vasectomy reversal in the Topic Center Fertility Treatments and Reversals.

Most infertility surgeries are outpatient procedures that do not require overnight stays in the hospital. Still, the decision to proceed with surgical treatment to improve fertility is complex.  Multiple factors need to be considered to optimize your chances for pregnancy.

Contributing author: Dr. Lowell Ku, infertility specialists at Dallas IVF