Laparoscopy uses key-hole surgery to look inside the pelvis with a flexible telescope and to treat and diagnose pelvic problems such as:-
- Tubal damage - previous infection, pelvic surgery or sterilisation may cause the tubes to become blocked or damaged. Damage may be near to the uterus (proximal) or near to the ovary (distal). Depending upon the extent of damage repair may be possible. If there is significant damage to the distal tube with fluid inside we may suggest sealing the tube near to the uterus to prevent this fluid affecting embryos implanting in to the uterus.
- Endometriosis – is a condition where the lining of the womb grows on other organs such as bladder, bowel, ovaries or in the pelvis itself. Treatment of endometriosis with laser can improve symptoms and may increase the chances of natural pregnancy.
Hysteroscopy allows us to look inside the cavity of the womb with a flexible telescope to both diagnose and treat uterine problems such as
- Adhesions – scar tissue caused by previous surgery, miscarriage or pregnancy.
- Uterine septum - a fibrous division inside the cavity. We may advise that coils (IUCD) are inserted and hormonal medication taken to encourage healing.
- Polyps – fleshy growths inside the uterine cavity which may prevent a pregnancy implanting.
Fibroids - non-cancerous growths of muscle in the wall of the womb, the size and location of which are important in the assessment of fertility.
- Sub-serosal – grow outside of the wall of the womb
- Intramural – grow in the muscle wall of the womb
- Sub-mucous – grow in the cavity of the womb
Occasionally fibroids which are large may need to be removed by making a larger cut on the bikini line (laparotomy) which requires a 2-3 day hospital stay.
In cases where no sperm is found in repeated sperm samples (azoospermia) sometimes sperm can be found in samples taken directly from the testicles. This can then be frozen for use in the future with ICSI treatment.
Link to London Fertility Surgery web-site