When you need help for infertility, there is a wide array of treatments available to help. Reproductive surgery is one of them. While the thought of surgery may be frightening, it is one of the best options available to help attain pregnancy. It is a major decision; one that you should be well-informed about. This guide explains the basics about reproductive surgery and what you need to know to help you decide if you want to consider it.
How Reproductive Surgery Can Help with Infertility
Sometimes, an anatomical problem is what prevents a couple from conceiving. There may be an obstruction somewhere in the reproductive system. Surgery can help rectify this obstruction, whether it is a fibroid or a misshaped uterine cavity. In men, varicose veins in the scrotum (varicoceles) are often a fertility problem. Both men and women who have had sterilization may also have reproductive surgery to try to regain fertility.
Types of Reproductive Surgery
Laparoscopy - This surgery is usually performed on endometriosis. The surgeon makes a tiny incision at your navel and places a fiber optic camera inside. This allows your doctor to see any abnormal tissue or areas of scarring. Then more small incisions are made to insert the instruments that are needed to perform the surgery.
Mini-laparotomy - In this type of reproductive surgery, the surgeon makes an incision in the abdominal wall, just above the pubic bone, to be able to reach the affected areas. The surgery is performed through this incision. The surgeon explores the pelvic area and corrects the problem. This procedure is often performed for scarring or obstruction.
Laparotomy - In a laparotomy, the surgeon makes a larger incision, either just above the pubic bone or from the navel down to the pubic hair area. This surgery may be needed for very severe pelvic scarring, and is not an outpatient procedure. It is also used to remove fibroids and reverse tubal ligation.
Varicocele repair - The surgeon makes a small incision and ties off the varicose vein, which restores fertility. A new method of reproductive surgery is being studied that involves blocking blood flow to the veins that are affected. In this procedure, a tiny incision is made in the patient’s neck or leg, and a catheter is inserted. The doctor then releases very small pellets and blood flow to the varicose vein is blocked.
All surgeries have risks, even reproductive surgery. Some patients have allergic reactions to anesthesia; however, this is quite rare. The procedure itself may have complications such as bleeding, infection or injury to other organs. If any complications occur, patients may have to stay in the hospital for a few days for further treatment. Be sure to discuss your full medical history with all your medical team before surgery, including your surgeon and anesthesiologist. This includes all medications you are currently taking or have taken within the past year.
Reproductive Surgery and Insurance Coverage
Coverage for infertility treatment, whether it is surgical or medical, varies from insurance plan to insurance plan. Before you have a reproductive surgery procedure, ask your doctor’s office to find out what portion, if any, of your procedure will be covered. In some cases, surgery to treat other problems, such as pelvic pain or abnormal bleeding in a patient with endometriosis, may be covered by insurance. This, in turn, may also help improve your fertility.
IVF Specialist Co-director, IVF Unit, Assuta Medical Center, Tel-Aviv (one...
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