Reproductive surgery

When couples seek help for infertility, they discover a wide array of available tests and treatments. While the thought of surgery can be frightening, reproductive surgery is one of the many options that we now have to help attain pregnancy.

How Can Surgery Help?

Sometimes, an anatomic problem prevents a couple from conceiving. Surgery can help fix the obstruction, whether it’s a scarred tube or an abnormally shaped uterine cavity. In men, varicoceles (varicose veins in the scrotum) can often be a problem. Men and women who have undergone sterilization (vasectomy or tubal ligation) may also undergo surgery to try to regain fertility.

endometriosis	fibroids

Which Surgery Is Done For Which Problem?

Doctors may recommend a surgical treatment based on the patient, her fertility problem, and the method with which the surgeon is most comfortable. If the surgery goes smoothly, most fertility procedures can be done on an outpatient basis.

• Laparoscopy: The surgeon makes a tiny incision at the belly button and places a fiber optic camera, allowing the doctor to visualize any scarring or abnormal tissue. Additional small incisions are made to introduce the instruments needed to perform the surgery;
• Mini-laparotomy: The surgeon makes an incision in the abdominal wall to be able to reach the affected areas. Mini-laparotomy is performed through a small incision located just above the pubic bone. The surgeon explores the pelvis and corrects the problem;
• Laparotomy: The surgeon makes a larger incision, either just above the pubic bone or from the belly button down to the pubic hair area. Laparotomy may be needed for very severe scarring of the pelvis, and is not an outpatient procedure.

• Laparotomy
• Hysteroscopy
• Laparoscopy
• Colpotomy which involves an incision through the vagina or

• Varicocele repair (also referred to as varicose veins in the scrotum): The surgeon makes a small incision, ties off the varicose vein, and restores fertility. A new treatment is being studied which involves blocking blood flow to the affected veins. A tiny incision is made in the leg or neck of the patient where a catheter is inserted and the doctor then releases pellets to block blood flow to the varicose vein.
• Reversal of vasectomy: This surgery needs to be performed by a surgeon experienced in microsurgery.

What Are The Risks Involved?

As with all surgeries, there are risks. Some patients have reactions to anesthesia, although these are quite rare. The procedure itself may cause bleeding, infection , or injury to other organs. If complications occur, patients may have to stay in the hospital for a few days.

Will My Insurance Cover These Surgeries?

Review Date: 2/19/2007
Reviewed By: Douglas A. Levine, MD, Gynecology Service, Memorial Sloan-Kettering Cancer Center, New York, NY. Review provided by VeriMed Healthcare Network.

A.D.A.M.'s health encyclopedia is accredited by URAC, also known as the American Accreditation Healthcare Commission (www.urac.org). URAC's accreditation program is the first of its kind, requiring compliance with 53 standards of quality and accountability, verified by independent audit. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial reviewers. A.D.A.M. is also a founding member of Hi-Ethics (www.hiethics.com) and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2002 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.