Surgical Procedures
Sometimes, the most effective way to treat infertility issues is through minor surgical procedures. In fertility medicine, we operate on a very small, sometimes even microscopic, scale most of the time on an outpatient basis.
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Small procedures with big benefits
Egg retrieval
One of the most common forms of surgery we perform at RSC is egg retrieval which is done as part of In vitro fertilization (IVF) or egg freezing.
During the retrieval, a fertility specialist gently removes eggs from each follicle on the ovaries using transvaginal ultrasound guidance. The patient is under anesthesia and the process takes 15 – 20 minutes. After a short recovery period, the patient returns home that day.
Hysteroscopy
A hysteroscope is a slim tube with a light and a camera at the end of it that is used to examine the uterine cavity. A hysteroscopy is performed with the patient under anesthesia to diagnose conditions such as uterine polyps, fibroids, adhesions, septum, or other conditions which may interfere with fertility or cause miscarriage.
Dilation and curretage (D&C)
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.
Laparoscopy
A laparoscopy is surgery performed through a small incision in the abdomen using a thin, lighted tube under general anesthesia. It can be used to confirm or treat such conditions as endometriosis, adhesions, or ovarian cysts. The process usually takes 30-90 minutes and the patient returns home same day.
Tubal ligation reversal
Typically in a tubal ligation, surgeons will tie the tubes or clip them shut, burn them closed, or block them. In order to reverse this, the surgeon performing the tubal ligation reversal surgery will make a small incision to access the uterus, ovaries, and Fallopian tubes and utilize small instruments to reconnect the ends of the tubes to the uterus with small stitches or remove any clips or blocking devices. If the tubes are successfully unblocked, it will allow for a sperm to reach the egg and fertilize it. The fertilized egg will then pass through the tubes and attach to the uterine walls, potentially resulting in a pregnancy. This is an outpatient surgery but may require 2-4 weeks off of work.
Removal of uterine fibroids
Surgery for uterine fibroids is recommended when fibroids cause excessive bleeding, fertility issues, or pelvic pressure. There are three surgical options: exploratory laparotomy with myomectomy (a major open surgery), laparoscopic/robotic-assisted myomectomy (a minimally invasive outpatient procedure), and hysteroscopic myomectomy (for fibroids within or extending into the uterine cavity). Uterine artery embolization is not advised for those seeking future pregnancies. Fibroid removal is generally recommended for fibroids in the uterine cavity, larger than 5 cm, or compressing fallopian tubes, while removal of smaller or multiple fibroids remains debated. Each procedure has its risks and benefits, but all are associated with symptom relief and potential fertility improvement.
