Laparoscopy & Hysteroscopy for Infertility

Laparoscopy is a surgical procedure that involves making one, two, or three very small cuts in the abdomen, through which the doctor inserts a laparoscope and specialized surgical instruments. A laparoscope is a thin, fiber-optic tube, fitted with a light and camera. Laparoscopy allows your doctor to see the abdominal organs and sometimes make repairs, without making a larger incision that can require a longer recovery time and hospital stay.

Laparoscopic surgery can treat some causes of infertility, allowing you a better chance at getting pregnant either naturally or with fertility treatments. Laparoscopy can be used to remove the scar tissue that's causing pain.

This procedure allows us to determine whether there are any defects such as scar tissue, endometriosis, fibroid tumours and other abnormalities of the uterus, fallopian tubes and ovaries. If any defects are found then they can sometimes be corrected with operative laparoscopy which involves placing instruments through ports in the scope and through additional, narrow (5 mm) ports which are usually inserted at the top of the pubic hair line in the lower abdomen. Because of the cost and invasive nature of laparoscopy it should not be the first test in the couples diagnostic evaluation. In general, semen analysis, hysterosalpingogram, assessment of ovarian reserve and documentation of ovulation should be assessed prior to consideration of laparoscopy. For example, if the woman has a clear ovulation problem or her male partner has a severe sperm defect then it is unlikely that laparoscopy will provide additional useful information that will help them conceive.

Some causes of infertility, like endometriosis, can only be diagnosed through laparoscopy. Laparoscopy allows your doctor to not only see what's inside your abdomen, but also biopsy suspicious growths or cysts.

What is Hysteroscopy?

Hysteroscopy is a procedure that allows your doctor to look inside your uterus in order to diagnose and treat causes of abnormal bleeding. Hysteroscopy is done using a hysteroscopy, a thin, lighted tube that is inserted into the vagina to examine the cervix and inside of the uterus. Hysteroscopy can be either diagnostic or operative.

What is Diagnostic Hysteroscopy?

Diagnostic hysteroscopy is used to diagnose problems of the uterus. Diagnostic hysteroscopy is also used to confirm results of other tests, such as hysterosalpingography (HSG). HSG is an X-ray dye test used to check the uterus and fallopian tubes. such as hysterosalpingography (HSG). HSG is an X-ray dye test used to check the uterus and fallopian tubes.

Additionally, hysteroscopy can be used with other procedures, such as laparoscopy, or before procedures such as dilation and curettage (D&C). In laparoscopy, your doctor will insert an endoscope (a slender tube fitted with a fiber optic camera) into your abdomen to view the outside of your uterus, ovaries and fallopian tubes. The endoscope is inserted through an incision made through or below your navel.

What is Operative Hysteroscopy?

Operative hysteroscopy is used to correct an abnormal condition that has been detected during a diagnostic hysteroscopy. If an abnormal condition was detected during the diagnostic hysteroscopy, an operative hysteroscopy can often be performed at the same time, avoiding the need for a second surgery. During operative hysteroscopy, small instruments used to correct the condition are inserted through the hysteroscopy.

When is Operative Hysteroscopy Used?

Your doctor may perform hysteroscopy to correct the following uterine conditions:
  • Polyps and fibroids Hysteroscopy is used to remove these non-cancerous growths found in the uterus.(HYSTEROSCOPIC POLYPECTOMY / MYOMECTOMY).
  • Adhesions Also known as Asherman's Syndrome, uterine adhesions are bands of scar tissue that can form in the uterus and may lead to changes in menstrual flow as well as infertility. Hysteroscopy can help your doctor locate and remove the adhesions. (HYSTEROSCOPIC ADHESIOLYSIS).
  • Septums Hysteroscopy can help determine whether you have a uterine septum, a malformation of the uterus that is present from birth. (HYSTEROSCOPIC REMOVAL AND RESECTION OF SEPTUM).
  • Abnormal bleeding Hysteroscopy can help identify the cause of heavy or lengthy menstrual flow, as well as bleeding between periods or after menopause. Endometrial ablation is one procedure in which the hysteroscope, along with other instruments, is used to destroy the uterine lining in order to treat some causes of heavy bleeding. (HYSTEROSCOPIC ENDOMETRIAL ABLATION).
  • Intrauterine foreign body and retained products of conception they can be removed by a hysteroscope without damaging the uterus and endometrium and without compromising the future fertility. (HYSTEROSCOPIC REMOVAL).

What are the Benefits of Hysteroscopy?

Compared with other, more invasive procedures, hysteroscopy may provide the following advantages:
  • Shorter hospital stay.
  • Shorter recovery time.
  • Less pain medication needed after surgery.
  • Avoidance of hysterectomy.
  • Possible avoidance of "open" abdominal surgery.

How safe is Hysteroscopy?

Hysteroscopy is a relatively safe procedure. However, as with any type of surgery, complications are possible. With hysteroscopy, complications occur in less than 1 percent of cases and can include:

  • Risks associated with anesthesia
  • Infection
  • Heavy bleeding
  • Injury to the cervix, uterus, bowel or bladder
  • Intrauterine scarring
  • Reaction to the substance used to expand the uterus

It's important to note that while complications are rare, they can still occur. However, the overall safety of hysteroscopy is quite high, and the procedure is generally well-tolerated by most patients.

To minimize the risks associated with hysteroscopy, it is typically performed by experienced healthcare professionals in a controlled medical setting, such as an operating room or outpatient clinic. The healthcare team takes precautions to ensure patient safety and minimize the chances of complications.

  • Complications occur in less than 1 percent of cases.
  • Risks associated with hysteroscopy include:
    1. Risks associated with anaesthesia.
    2. Infection.
    3. Heavy bleeding.
    4. Injury to the cervix, uterus, bowel, or bladder.
    5. Intrauterine scarring.
    6. Reaction to the substance used to expand the uterus.
  • Complications are rare but can still occur.
  • Hysteroscopy is typically performed by experienced healthcare professionals in a controlled medical setting.
  • Precautions are taken to ensure patient safety and minimize the chances of complications.
  • It's important to discuss the procedure with your healthcare provider to address any concerns or questions specific to your case.

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