Laparoscopy for Infertility Treatment

What is a Laparoscopy?

Laparoscopy is an invasive method that is used to diagnose and subsequently, treat the problem of infertility. In this surgical procedure, your doctor may make two to three incisions in your abdominal region. A laparoscope is used for this process – it is a very thin surgical instrument that has a camera and light fitted on it. This helps the doctor identify and, potentially, correct the problem. In some cases, the doctor may even make bigger incisions for the surgery, and you may have to stay in the hospital for a few days.

When is a Laparoscopy Procedure Recommended?

A laparoscopy is not the first course of treatment for infertility. Your doctor may recommend this after trying various other methods or suggesting other infertility options. Here are some of the reasons your doctor may advise you to get a diagnostic laparoscopy for infertility:

• If your doctor establishes an ectopic pregnancy, which is a fatal condition.
• If your doctor suspects pelvic adhesions or Pelvic inflammatory Disease.
• If your doctor diagnoses moderate or severe endometriosis.
• If you experience pain and discomfort during sexual intercourse.
• If you experience severe pain and cramps during your menstrual cycle.

In many cases, your doctor may treat the problem during the laparoscopic procedure (though not in all cases). The following are some infertility issues for which your doctor may recommend laparoscopic surgery:

• If you have PCOS or polycystic ovarian syndrome. In such a case your doctor may recommend ovarian drilling. Polycystic ovarian syndrome hampers ovulation; to correct this, your doctor may puncture the ovaries at various places to drill.

• If you have a fibroid that causes intense pain or blockage in the fallopian tubes (which also affects the uterine cavity).

• If you have ovarian cysts that are blocking the fallopian tubes and causing severe pain. In some cases, your doctor may even suggest an ultrasound-guided-needle procedure to drain the cyst. However, removal or drainage of large endometrial cysts may adversely affect your ovarian reserves.

• In case endometrial deposits are the cause of infertility, your doctor may recommend removing them. While some doctors are of the view that the removal of deposits improves your chances of conception, others feel it should be removed only if they are causing intense pain and discomfort.

• Your doctor may recommend surgery if your fallopian tubes are blocked. However, the success rate for laparoscopy in treating infertility through tubal repair varies to a great extent. If you are considering IVF after a laparoscopy, your doctor may recommend skipping this procedure and proceeding with IVF directly.

• In case your doctor suspects hydrosalpinx- a condition where the fallopian tube has developed a specific kind of blockage – your doctor may recommend removing the tube.

What are the Benefits of Laparoscopy for Infertility?

Here are some of the benefits of laparoscopy for infertility:

• Certain infertility defects can only be established through laparoscopy.

• It helps the doctor take a comprehensive and detailed look inside your abdominal region to identify various issues that may be causing infertility.

• A laparoscopy is also effective in treating some causes of fertility, which may increase your chances of getting pregnant by natural means or by other infertility treatment options.

• It helps in getting rid of pelvic pain and discomfort.

• It also helps in removing endometrial deposits, scar tissue and fibroids.

• This surgical method is less invasive in comparison to open surgery, which means less pain, lower blood loss, smaller incisions and faster recovery.

How Is Laparoscopy Performed?

Once your doctor recommends a laparoscopy, you will be told about the procedure in detail. You may have to prepare for the surgery in advance.. You will be told not to eat for at least 8 to 10 hours before the surgery. The procedure is performed under general anaesthesia. Before the procedure begins, you will be put on an IV will through which various medicines will get administered.

Once the anaesthesia takes effect, your doctor will begin with the procedure. A number of small incisions will be made in your abdominal region. After the incisions are made, arbon dioxide is pumped into the incision to create space for the insertion of the laparoscope. Once the volume of carbon dioxide is sufficient, the doctor will insert the laparoscope to look at your pelvic organs. In some cases, your doctor may extract some tissue for a biopsy. Apart from the pelvic organs, your doctor may also want to check other abdominal organs, and may make a few more incisions for this. Your doctor will carefully look for scar tissue, cysts, fibroids or endometrial deposits. Your reproductive organs will be observed internally to detect abnormalities or defects.

In addition, your doctor may inject some dye from the cervix to check for any kind of blockages in the fallopian tubes. Your fallopian tubes are likely to be examined as well to rule out the probability of an ectopic pregnancy.

Is the Procedure Painful?

The laparoscopic procedure is performed under the effect of general anaesthesia, which means you will not feel anything during the entire procedure. However, once the effect of anaesthesia subsides after the surgical procedure is over, you may feel sore at the site of the incision. In case your doctor removes tissue for biopsy, then your stomach may feel tender too. Because of the carbon dioxide in your abdominal region, you may feel bloated and may experience pain around your shoulders. Your throat may also pain due to the tube that will have been inserted into your throat to facilitate your breathing during the procedure. These are very common things that you may experience after the surgery , which will subside in a few days.

Recovery Time of Laparoscopy Surgery for Infertility

Post your surgery, you may get discharged the same day if there are no complications involved. Your doctor will recommend rest for at least two to three days. However, you may take a couple of weeks to recover completely. You will be given various medicines for a speedy recovery, which may include antibiotics and painkillers. Get immediate medical help if you experience:

• Pus or intense pain at the site of the incision.
• Fever, which is 101 or higher.
• Severe abdominal pain and discomfort.

Risks and Side Effects of Laparoscopy for Infertility

Just like any surgical procedure, there are some risks and side-effects associated with laparoscopy . It is seen that out of 100, 1 or 2 women on an average may develop some or the other kind of complication after laparoscopy. Here are some commonly experienced surgery complications:

• Irritation of skin at the incision site
• Bladder infection
• Adhesions
• Infection at the site of incision
• The occurrence of hematomas in the abdominal walls

These are some lesser-known complications that may arise after the surgical procedureSevere allergic reaction

• The occurrence of blood clots
• Severe damage to the blood vessels or abdominal organs
• Urine retention
• Damage to the nerves
• Complications associated with general anaesthesia
• Death (though very rare)

What Do the Results of Laparoscopy Mean?

In case a tissue is extracted during laparoscopy, it will be given for further tests. Usual test results indicate an intestinal blockage, hernia, or abdominal bleeding. Results may also show that all your internal organs are in a healthy state.

What If the Results Are Abnormal?

Here are some kinds of abnormalities that may be seen during the laparoscopic procedure:

• Detection of fibroids
• Adhesions or surgical scars
• A hernia
• Inflammation of the intestines or appendicitis
• Presence of tumours or cysts
• Some trauma or injury to a particular internal organ
• Inflammation of the gallbladder or cholecystitis
• An abnormal condition where the uterine lining grows outside the uterus instead of growing inside, also known as endometriosis
• Infection of reproductive organs or Pelvic Inflammatory Disease
• Cancer

Can a Laparoscopy Affect My Ability to Conceive?

No. The good news is that a laparoscopy rarely impacts your ability to conceive and usually causes no hindrance in getting pregnant. In fact, in some cases, it may even increase your chances of conception.

Laparoscopy is a safe option to consider when you’re having trouble conceiving. Once the procedure is over, your doctor will discuss your chances of getting pregnant naturally and other associated options.