Minimally Invasive Laparoscopic or Hysteroscopic Fertility Surgery
As part of your fertility evaluation, Dr. James or Dr. Munch will determine if you have a need for fertility surgery to improve your chance of pregnancy. Our typical basic fertility evaluation will include a medical history, a physical examination, a transvaginal ultrasound, and an HSG or a saline sonogram. Our doctors will be looking for signs of abnormalities such as fibroids, polyps, mullerian anomalies (developmental abnormalities of the uterus and/or Fallopian tubes), endometriosis, pelvic adhesions, and ovarian cysts.
Types of Fertility Surgery
Laparoscopy: This outpatient surgery involves passing a small surgical telescope into the pelvis through very small incisions in the abdomen. If abnormalities are identified, such as endometriosis, ovarian cysts, uterine fibroids, or pelvic adhesions, then additional surgical instruments can be inserted into the abdomen to treat the problem. Most patients return to work within 2-3 days following laparoscopy.
Laparotomy: This surgical approach requires a larger (6-10 cm) incision across the lower abdomen. It is commonly performed in order to remove large uterine fibroids or to treat conditions that are not amenable to laparoscopic correction. Most patients stay in the surgery center or hospital overnight and then return to work in 1-2 weeks following a laparotomy. A complete recovery may take as long as four to six weeks.
Hysteroscopy: This surgery involves placement of a surgical telescope through the vagina and cervix, and into the uterine cavity. When performed without laparoscopy, hysteroscopy can be performed under IV sedation. Once the hysteroscope has been introduced into the uterus, polyps, fibroids, uterine septa, and intrauterine adhesions can be clearly visualized and treated. Most women resume normal activity the day after undergoing hysteroscopy.