With major advancements in assisted reproductive science and technology, and resulting increases in IVF success rates, the need for surgery to treat infertility has been reduced. However, in certain cases, surgery may be the only option available to restore fertility.
Procedures are available to treat fallopian tube disease, reversal of a tubal ligation, reversal of a vasectomy, endometriosis, ovulation problems, ovarian cysts, uterine fibroids, and structural problems of the uterus.
When surgery is necessary, minimally invasive procedures provide good outcomes including improving the odds of conception.
Minimally Invasive Reproductive Surgery
Laparoscopy is a minimally invasive procedure performed by our board certified, highly trained infertility experts to diagnose and treat gynecological problems.
- Diagnostic Laparoscopy
A diagnostic laparoscopy may be recommended to examine the uterus, fallopian tubes, ovaries and pelvis when a patient has pelvic pain, a history of pelvic inflammatory disease, ovarian cysts, adhesions, previous pelvic surgery, and ectopic pregnancy. It can also detect abnormalities in the fallopian tubes, ovaries and uterus.
- Operative Laparoscopy.
Operative Laparoscopy may be recommended to treat pelvic disorders at the same time that they are diagnosed. It can treat adhesions near the ovaries and fallopian tubes, open blocked tubes, remove cysts, and treat ectopic pregnancies.
- Laparoscopy is often used to diagnose and treat certain conditions that cause infertility such as endometriosis and pelvic adhesions, which can only be detected through visualization. Laparoscopic surgery provides excellent magnification permitting more precise surgery.
- It can be used to reverse a tubal ligation, and repair damaged fallopian tubes. Treatment to repair damaged fallopian tubes has been shown to increase the IVF success rates two fold.
- Under general anesthesia, a small camera is inserted through tiny incisions (<1.0cm) made in the abdomen, to visualize the reproductive organs. If repairs are needed, surgery can be completed through these small incisions.
- The advantages are fewer and smaller incisions, less blood loss, reduced postoperative adhesions (internal scarring), and reduced recovery time with fewer complications, and less blood loss. The majority of the time, laparoscopic surgery is a same-day procedure, eliminating the need for an overnight hospital stay.
Laparoscopy examines the outside the the pelvic organs. A diagnostic hysteroscopy allows the surgeon to see the inside of the uterus to evaluate abnormalities that may be causing miscarriages or abnormal uterine bleeding such as a uterine polyp or fibroid. It can also diagnose scarring, and congenital conditions.
Hysteroscopy involves the use of a thin camera placed through the cervix into the uterus. When an abnormal finding is visualized, microscopic surgical instruments can be used to remove the abnormality such as the polyp, fibroid, uterine septum or scar tissue. This is a low risk procedure and recovery time is minimal.
Fertility – Sparing Myomectomy for Uterine Fibroids, Uterine Septum and Uterine Scarring
Myomectomy is the only procedure that treats symptomatic fibroids located within the uterus and preserves fertility. Myomectomy can enhance fertility and successful pregnancy, in women with infertility due to a distorted uterine cavity caused by the presence of one or more uterine fibroids.
Uterine fibroids are typically benign growths of the uterine muscle that can cause pelvic pain, infertility, bladder urgency, fecal urgency, heavy vaginal bleeding, irregular vaginal bleeding, severe anemia or pain with intercourse. Fibroids that are very large or distort the cavity often can cause infertility or miscarriages.
A myomectomy is a surgical procedure performed with the use of a laparoscopy or hysteroscopy to remove the fibroids and repair the uterus. This surgery requires expertise as myomectomy has up to an 85% chance of scarring which could result in abnormalities of the uterine cavity or fallopian tubes that can result in further infertility. Please consult your doctor at Virginia Fertility Associates to discuss this surgical option.
Hysteroscopy myomectomy is the procedure used when fibroids located within or mostly within the cavity are removed by placing a camera with micro-instruments through the cervix into the uterus. This is a very safe, quick, outpatient procedure that can allow the patient to go home the same day and reduces time away from work.
Hysteroscopy Septum removal is a procedure to remove a uterine septum. Uterine septum is the most common congenital abnormality resulting in recurrent miscarriages. Once the septum is removed, often the risk for recurrent miscarriage is resolved. It is a very complicated surgery that should only be done with the expertise of a board-certified infertility doctor like the specialists at Virginia Fertility Associates in Richmond, VA.
Robotic – Assisted Reproductive Surgery
Robotic- assisted surgery is a type of minimally invasive surgery. Procedures that are technically challenging can be performed with robotic assistance due to its ability to magnify and view structures in 3D. This allows very precise surgery that would otherwise require a microscope, such as is used in tubal reversal surgery.
At Virginia Fertility Associates, we offer state-of-the-art Da Vinci® Robotic surgery services and provide a comprehensive array of minimally invasive surgical techniques to help patients avoid long recovery, with less pain and get better outcomes.
Why choose Virginia Fertility Associates?
When choosing your reproductive team, you want experienced physicians. They are highly trained, board-certified, experienced in the most advanced surgical technologies and have outstanding success rates. We offer a private, comforting, and compassionate environment where you will receive personalized care.
Richmond Center for Fertility has partnered with only the best local board-certified urologists in the area to manage male reproductive problems. They can perform the following procedures:
- Repair of a varicocele (varicose veins in the scrotum). Microsurgical reconstruction preserves tissue and improves outcomes. It is minimally invasive outpatient surgery to enhance sperm movement, concentration and structure.
- Vasectomy reversal by reversing the blockage of the vas deferens due to the vasectomy.
- Sperm retrieval such as Testicular Sperm Extraction (TESE) can be used for epididymal or vas deferens obstruction from infection, cystic fibrosis, or vasectomy. Furthermore, TESE can be used in instances of paralysis or genetic conditions where sperm production is extremely low. Once the sperm is obtained, the doctors at Richmond Center for Fertility can use assisted reproductive technologies such as IVF to create the family that you desire. TESE is safe and extremely effective outpatient surgery that can get viable sperm when present. Our Lab Director Dr. Denis Matt, PhD, HCLD personally goes to each procedure to evaluate and confirm healthy sperm is obtained.
- Ejaculatory duct obstructionsare often due to infection, prostatitis, and epididymitis or any previous bladder, prostate or urethra surgery. Ejaculatory duct obstruction is the underlying cause of male infertility in about 4% cases. Transurethral resection can improve semen quality.