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Surgery

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Fertility Surgery

After an initial assessment, your fertility specialist may recommend surgery, either to investigate the cause of infertility or to treat problems that are making it difficult for you to conceive.

For both women and men, surgery is sometimes the most effective solution for accurately diagnosing or correcting an infertility problem.

Sometimes the most effective way to treat infertility issues is through minor surgical procedures. These smaller surgeries often yield transformative results.

While the thought of surgery may cause anxiety in some patients, we want you to feel assured that our specialist is among the very best worldwide, and frequently win awards for their surgical skills.

Which fertility conditions require surgery?

For women, reproductive surgery includes clearing up scar tissue that may block the fallopian tubes and encase the ovaries (lysis of adhesions), opening blocked tubes (tuboplasty or neosalpingostomy), removal of fibroids (myomectomy), treatment of endometriosis, removal of ovarian cysts (ovarian cystectomy), treatment of problems associated with the endometrial cavity (hysteroscopic polypectomy, myomectomy, lysis of intrauterine adhesions, incision of uterine septum) and correction of pelvic anomalies.

For men, surgical treatments include vasectomy reversal and varicocele repair, a procedure treating varicose veins in the scrotum.

In any case, our fertility specialists offer a variety of innovative, advanced fertility surgeries to address your unique situation.

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nezhat.org. Image source: Infertility determining a diagnosis. Accessed via https://nezhat.org/treatment-of-infertility/infertility-determining-a-diagnosis/

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1. Dilation and Curettage (D&C)

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Image source: Parlomarhealth. Accessed via https://www.palomarhealth.org/womens-services/center-of-excellence-for-minimally-invasive-gyn/dilation-and-curettage/

A D&C is performed under anesthesia when there is tissue in the uterus that needs to be removed. It can be used to diagnose abnormal bleeding or to treat a miscarriage if needed to remove the pregnancy tissue. This tissue is examined under a microscope for further insights into your health condition or miscarriage.

2. Diagnostic laparoscopy and hysteroscopy

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Image source: Parlomarhealth. Accessed via https://www.palomarhealth.org/womens-services/center-of-excellence-for-minimally-invasive-gyn/dilation-and-curettage/

This test is an important part of a fertility evaluation but it is usually one of the last tests to be done as it is a more invasive procedure. If your history or other tests show an obvious need for IVF, your fertility specialist may advise deferring or not performing this investigation.

Laparoscopy takes place under general anesthesia with small incisions made at or just below the navel and the pubic hairline. A laparoscope (a small-diameter telescope) is passed through the incision, enabling your fertility specialist to view the ovaries, fallopian tubes, uterus and pelvic cavity for abnormalities.

Your fertility specialist can check that your tubes are open (tubal patency) by injecting dye through the uterus and observing it spill or not through the ends of the fallopian tubes.

Laparoscopy is useful for diagnosis and treatment (Removal) of:

  • Endometriosis lesions
  • Ovarian cysts
  • Uterine fibroids
  • Tubal adhesions
  • Hydrosalpinx

Advantages of laparoscopy and hysteroscopy in the treatment of infertility

  • Many diseases and abnormalities of the abdomen and pelvis can be safely treated using laparoscopy.
  • Special laparoscopic instruments allow the surgeon to incise, biopsy, cauterize, or vaporize problem areas without the need for a large abdominal incision.
  • Smaller incisions mean less discomfort and pain and reduced recovery time. Laparoscopic patients typically can return to normal activities after only two to three days of recovery.

Laparoscopic treatment of endometriosis and tubal surgery

If your fertility specialist suspects that you might have endometriosis, he/she may recommend a laparoscopy to confirm this diagnosis. Treatment depends on the extent of the condition and other symptoms that you may have.

It may involve surgical removal of the endometriosis and associated scar tissue at the time of the laparoscopy or hormone treatment to suppress the menstrual cycle and inhibit the growth of endometriosis.

If treatment for endometriosis does not result in a successful pregnancy, IVF will often be an appropriate option.  Your fertility specialist will advise you on the most appropriate combination of treatments.

If you have any tubal damage or abnormality, this will be diagnosed during the laparoscopy. Some of these conditions may adversely affect your chances of success with IVF unless treated.

Your fertility specialist may recommend tubal surgery before starting IVF treatment in order to improve your chance of natural conception.

If tubal surgery does not result in a successful pregnancy, or where damage to the tubes and other pelvic organs is so severe as to make surgery unlikely to be successful, IVF will be the treatment option with the best chance of success.

Microsurgery may be used for procedures such as the reversal of sterilization (tubal anastomosis), the re-opening of blocked tubes (salpingostomy) and the removal of scar tissue around the uterus, tubes and ovaries (adhesiolysis).

Microsurgery involves specialized operative techniques, including the use of an operating microscope. Surgeons trained in microsurgery use these skills and techniques for the repair of very small structures or obstructions in the fallopian tubes.

Hysteroscopy uses another small-diameter telescope called a hysteroscope. This enables your fertility specialist to assess the uterine cavity for abnormalities such as polyps, adhesions or fibroids.

It is similar in technique and provides detailed information about the endometrial cavity and also offers both accurate diagnosis and the option of treatment during the same procedure.

Male Fertility Surgery

Men with certain types of infertility can best be treated with:

  • Varicocele Repair: This outpatient surgical procedure easily corrects enlarged veins in the scrotum that can cause low-count or poor-quality sperm.
  • Ejaculatory Duct Resection: A simple one-hour procedure that removes cysts, stones or other materials obstructing the volume of sperm flowing through the duct. The blockage is diagnosed with an ultrasound.
  • Vasectomy Reversal: This procedure reconnects the male reproductive tract that has been closed off by a vasectomy, even after a long period of time. The microsurgery procedure can also reverse blockages in a man’s reproductive tract.

How long does fertility treatment take?

Fertility treatment duration will vary depending on the extent of your condition and the existence of other symptoms. At Footsteps to fertility Nairobi, we will administer the most effective treatment plan to ensure successful pregnancy afterward.

How do I check my fertility?

Fertility tests are an essential part of fertility treatment steps in most Fertility clinics in Nairobi. At Footsteps to Fertility Nairobi, we will conduct multiple tests to identify the cause of infertility. We will do laparoscopic surgery for infertility, Uterine evaluation, Immune testing, Ovarian reserve testing, Ovulation tests, and Tubal patency tests in females and include semen analysis, testicular biopsy, scrotal ultrasounds, and sperm DNA testing in males.

How can I check my fertility at home?

Checking your fertility at home is similar to a pregnancy test. One way to do this is the FSH test that evaluates the FSH levels in your urine. Elevated levels indicate a decreased ovarian function. For this test, you can collect your first urine of the day in a small cup, dip the testing stick in it, and then place it on a flat surface to allow the results to register. The test can take up to 45 minutes, depending on the home test kit you purchase. You should complete this test on the third day of your menstrual cycle and time the test as per the instructions.
What are the signs of infertility in females?

Inability to get pregnant is the main sign of infertility in females. This is usually preceded by too long or too short, absent or irregular menstrual cycles, which are signs of anovulation. If you have a history of painful or irregular periods, miscarriages, endometriosis, cancer, or pelvic inflammatory disease, you should equally visit our Fertility Clinic for examination. At Footsteps to Fertility Nairobi, we will be glad to walk you through fertility treatment to fulfill your dream of becoming a mother.

What are the signs of infertility in males?

In males, the inability to conceive is a sign of infertility, given that males contribute 40 -50% of this process. This could result from a low sperm count, blockages of sperm, chronic health problems, injuries, illnesses, and lifestyle choices. If you are dealing with male infertility, please contact us for evaluation and treatment.

At Footsteps To Fertility Centre, we turn to fertility surgeries primarily to correct anatomic defects that may be impairing your ability to conceive.

Feel free to contact us, chat with us or directly reserve an appointment below. We are more than happy to maximize our patient’s chances of having a baby – while treating patients with compassion as individuals throughout their fertility journeys.

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