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Laparoscopy for Infertility

Laparoscopy is a surgical procedure that allows a fertility specialist 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, uterine fibroids and blocked Fallopian tubes—all of which can cause infertility.

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What are the advantages of laparoscopy for infertility?

Laparoscopy will allow the diagnosis of infertility problems that would otherwise be missed. For instance, 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 than 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.

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Generally, laparoscopy should be reserved for couples who have already completed a more basic infertility evaluation including assessing for ovulation, ovarian reserve , ultrasound and hysterosalpingogram for the female and semen analysis for the male.

Some couples may elect to skip laparoscopy in favor of proceeding to other fertility treatments such as fertility medications combined with intrauterine insemination or in vitro fertilization .

There may be instances in which the fertility doctor may have a high suspicion for finding problems with laparoscopy. If a woman had a history of a severe pelvic infection or a ruptured appendix, this would increase the likelihood that she may have pelvic adhesions and therefore more likely to benefit from laparoscopy.

What to expect after laparoscopy

Risks associated with laparoscopy

The risks associated with laparoscopy are of the same type that occur with traditional surgery. Problems from anesthesia, bleeding  and infections can occur with either type of surgery.

The risk of damage to the bladder, bowel and blood vessels is also possible with either type of 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 nausea.

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. Other women may require a few weeks.

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