Laparoscopy for IVF Treatment

Laparoscopy is a surgical procedure that allows a fertility doctor to see inside of the abdomen. In a female, the uterus, fallopian tubes and ovaries are located in the pelvis which is at the very bottom of the abdomen. Laparoscopy allows the fertility doctor to see abnormalities that might interfere with a woman’s ability to conceive a pregnancy. The most common problems are endometriosis , pelvic adhesions , ovarian cysts and uterine fibroids .

When Is Laparoscopy Recommended?

Your doctor may suggest laparoscopic surgery to help diagnosis a cause for infertility. Usually, it’s performed only after other infertility testing has been completed, or if symptoms warrant testing.

Possible reasons your doctor may recommend diagnostic laparoscopy include:

You experience pain during sexual intercourse
You have severe menstrual cramps or pelvic pain at other times in your cycle
Moderate to severe endometriosis is suspected
Pelvic inflammatory disease or severe pelvic adhesions are suspected
Your doctor suspects an ectopic pregnancy (which can be life-threatening if left untreated)

If a diagnostic laparoscopy finds problems, the reproductive surgeon will repair, remove, or otherwise treat the issue right away.

Laparoscopic surgery may be used to surgically treat some causes of female infertility. Your doctor may recommend surgery if:

Hydrosalpinx is suspected: This is a specific kind of blocked fallopian tube. Removing the affected tube can improve IVF success rates.

Endometrial deposits are suspected of reducing your fertility. This is rather controversial, with some doctors saying removal is only warranted if you’re in pain, and others saying it can improve pregnancy success rates and is worth doing even if pelvic pain isn’t a problem.

Surgery may be able to unblock or repair a fallopian tube. Success rates vary greatly when it comes to tubal repair. If IVF is going to be required even after surgery, then going straight to IVF is a better choice. If the woman is young and all other fertility factors look good, surgical repair may be worth trying first.

An ovarian cyst is suspected of causing pain or blocking the fallopian tubes. Sometimes, drainage of the cyst with an ultrasound-guided needle is better. Removal of a large endometrial ovarian cyst may reduce your ovarian reserves. Your doctor should discuss this with you.

A fibroid is causing pain, distorting the uterine cavity, or blocking your fallopian tubes.

You have PCOS and your doctor recommends ovarian drilling. Laparoscopic ovarian drilling involves making three to eight tiny punctures into the ovaries. In women with PCOS who have not ovulated on fertility drugs, this procedure may enable them to ovulate on their own. However, the risks may not outweigh the benefits, and its use is controversial.

Why Laparoscopy for IVF Treatment Important?

Some causes of infertility can only be diagnosed through laparoscopy. (Endometriosis, for example.) Laparoscopy allows your doctor to not only see what’s inside your abdomen but also biopsy suspicious growths or cysts.

Also, laparoscopic surgery can treat some causes of infertility, allowing you a better chance at getting pregnant either naturally or with fertility treatments.

However, the most important reason for diagnostic laparoscopy is if you’re experiencing pelvic pain.

Laparoscopy can be used to remove scar tissue, a fibroid, or endometrial deposits that are causing pain.

What to expect post laparoscopy surgery

The incisions will be covered with bandages that can be removed after twenty four hours. The fertility doctor will give prescriptions for postoperative pain and for nausea. The pain medicine will almost always be needed, the nausea medicine may or may not be needed.

The length of time needed for recovery will depend on the type of procedure that was done, the length of time the surgery took, the number of incisions that were made, whether the patient has had surgery previously, the state of health the patient was in before the surgery, whether any complications occurred and what the tolerance of the patient is naturally.

The patient can eat or drink whatever she feels up to having after an uncomplicated laparoscopy for infertility problems. Due to the anesthesia, she should rest for twenty four hours. Generally thereafter, she may resume normal activities as soon as she feels well enough.

Depending on the type of procedure, some women may be able to return to work in a few days

Laparoscopy V/S IVF

Two commonly encountered problems during a laparoscopy, pelvic adhesions and endometriosis, can also be effectively treated using IVF. Since IVF is less invasive than laparoscopy and has a very high success rate, some couples will opt to skip laparoscopy and proceed directly to IVF. Even if a woman has severe adhesions that are not treated, this would not impact on her ability to conceive a pregnancy with IVF.

Advantages of laparoscopy for infertility

Laparoscopy will allow the diagnosis of infertility problems that would otherwise be missed. For example, a woman who has severe endometriosis can be identified by using ultrasound. A woman with mild endometriosis can only be identified using surgery such as laparoscopy.

Another problem that can only be identified through surgery are pelvic adhesions. Also known as scar tissue, adhesions cannot be seen with ultrasound, x-rays or CT scans. Adhesions can interfere with the ability to conceive if they make it more difficult for the egg to get into the fallopian tube at the time of ovulation.

Many people view laparoscopy as a less invasive surgery that traditional surgery. Traditional surgery requires making an incision in the abdomen which is several centimeters long. This in turn means that the patient has to spend two to three nights in the hospital. Laparoscopy utilizes one to three smaller incisions. Each incision may be one half a centimeter to a full centimeter in length. Most often, patients who have had a laparoscopy will be able to go home the same day as the surgery. In other words, a hospital stay is not usually required.