Surgery is often an effective treatment, depending upon the cause(s) of infertility. Most reproductive surgery is done laparoscopically. The laparoscopy requires small openings in the abdomen that usually heal with little or no scarring. Laparoscopic surgery is usually done on an outpatient basis, the recovery time is much shorter than conventional surgery, and pain is greatly reduced.

Reproductive endocrinologists fertility specialists receive years of advanced training in reproductive surgery. This training enables the specialist to use microsurgical techniques that dramatically reduce surgical complications. Many conditions can be treated during the diagnostic laparoscopy, which is a potential advantage of having a fertility specialist perform the procedure in sub fertile women.

Endometriosis is a common cause of infertility, and depending upon the extent, is often treated with laparoscopic surgery and perhaps with medications like Lupron. The fertility specialist will painstakingly attempt to remove all endometriotic lesions. Some data suggest that even small amounts of endometriosis can negatively affect fertility rates.

Sometimes a patient may wish to have a surgical reversal of a previous tubal sterilization procedure. Whether or not this procedure can be successfully performed depends upon many factors including how and where the tubes were "cut". Age can play a factor effecting whether or not tubal reconnection or IVF is recommended. Fertility can decline rapidly and some older women may not have enough time to achieve pregnancy after the procedure. Success rates after tubal reconnection are excellent in women with limited tubal damage, good day 3 FSH levels, and in those that are 35 years of age or younger. A good sperm count in the male is also a prerequisite for sterilization reversal.

Fibroids (leiomyomas) are sometimes associated with infertility and miscarriage. If they are a problem, they are usually removed by opening the abdomen. Rarely, in women desiring reproductive potential, they are removed through the laparoscope. Fibroids within the uterine cavity can often be removed using a hysteroscope.

Hysteroscopic surgery (passing transvaginally through the cervix to enter the uterus) is also done to remove polyps, scar tissue, and to resect uterine septums (sometimes associated with miscarriage).

 

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