Learn how surgically evaluating infertility at TFC

Many factors can cause female infertility. Among the most common are ovulation disorders, fallopian tube disease, endometriosis, and uterine defects. While medication can help manage problems with ovulation, surgically evaluating infertility is another option.

Sonogram imaging of the uterus and ovaries may show conditions such as ovarian cysts or fibroids (benign muscle tumors) that can compromise fertility. Another common component of the fertility evaluation is the “dye test”, or hysterosalpingogram (HSG). This exam evaluates the uterine cavity and patency of the fallopian tubes. If either of these tests is abnormal, your doctor will likely recommend a surgical procedure for evaluation and treatment of the problem.

Tests for surgically evaluating infertility

The most common surgical treatments include laparoscopy and hysteroscopy. These are both minimally invasive outpatient procedures that involve insertion of a small telescope through either the belly button (laparoscopy) or cervix (hysteroscopy). These telescopes are attached to cameras which are then connected to computer monitors so that the pelvic structures can be easily visualized by the operating room personnel.

Surgical treatment options

Your doctor can treat most pelvic and uterine abnormalities while surgically evaluating infertility. Endometriosis may be present in the absence of any symptoms such as heavy, painful periods. It can occur even when the sonogram or HSG is normal. Laparoscopy is the only reliable method to make the diagnosis of this condition and is also the best way to treat the disease, usually with laser or resection. The recovery time for hysteroscopy is usually 24 hours and for laparoscopy 2 to 3 days before resuming normal activities.

Occasionally, women will have a significant anatomic condition that requires a more invasive surgical approach. The most common problem is large or multiple uterine fibroids that extend deep into the uterine muscle. In this situation, the doctor makes an incision in the lower abdomen (“bikini cut”). He or she then removes the fibroids and repairs uterus through this incision. This procedure is a mini-laparotomy. It typically requires an overnight stay in the surgical unit and several weeks of recovery.

For many women, surgical evaluating infertility will result in the ability to conceive naturally or with minimal intervention. Reproductive endocrinologists receive an average of three years of additional training in these specific procedures compared to general gynecologists and are uniquely qualified to provide these fertility-enhancing treatments.

For more information about surgically evaluating infertility, contact us to learn more.