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Role Of Laparoscopy In Treating Infertility

By Medical Expert Team

Apr 14 , 2022 | 7 min read

Infertility is defined as the inability to conceive within one year of unprotected regular intercourse. Men and women have infertility resulting from tubal infections, ovulation disorders, endometriosis, cervical and uterine complications, and male factor infertility. According to the world health organization (WHO), the leading cause of infertility includes malnutrition, pelvic tuberculosis, and recurrent infections causing the blockage in tubes.

Doctors have adopted doing laparoscopies for infertility diagnosis and treatment. The procedure involves using a laparoscope to examine the reproductive system. This helps identify abnormalities in the system to determine the best treatment method. Your doctor can recommend laparoscopy in case of unexplained pelvic pain. Doctors don’t use the procedure in the first line of treatment since it only assesses problems that make conception difficult.

Laparoscopy is a non-invasive procedure that offers a panoramic and magnified view of the pelvic organs. A doctor can perform surgery during diagnosis. It has played a crucial role in diagnosing and treating pelvic abnormalities in females. It improves fertility through surgery in the uterus, ovaries, pelvic, peritoneum, and fallopian tubes. If you have unexplained infertility, your doctor may recommend a laparoscopy to check and correct problems in the reproductive organs.


What Causes Infertility?

Many things can cause infertility, but for women, the major causes are:

  1. Ovulation disorder

Ovulation disorders inhibit releasing the egg in some women, while in others, ovulation only occurs in some cycles reducing the chances of conception. These disorders include

  1. Scarring From Surgery

Pelvic or cervical surgery can damage and scar surrounding organs, including the uterus and fallopian tubes.

  1. Fibroids

These are non-cancerous growths that prevent attachment of the fertilized egg in the womb or block the fallopian tubes.

  1. Endometriosis 

This is a medical condition where the tissue lining the womb grows in other parts, such as the ovaries resulting in damage.

  1. Pelvic Inflammatory Disease (PID)

PID is a bacterial infection of the female upper genital tract that can cause damage and scarring on the fallopian tubes.

In males, the major cause of infertility is the malefactor, including:

  • Poor quality semen and low sperm count
  • Testicle disorders emanating from infection, surgery, and cancer
  • Ejaculation disorders that inhibit semen release 

Ways of Diagnosis for Infertility

Doctors can use various methods to diagnose infertility, depending on your situation. 

  1. Ovulation Testing

You can do this procedure at home using an ovulation prediction kit to detect the amount of luteinizing hormone. It can also be done in the hospital through a blood test to check for progesterone hormone produced during ovulation.

  1. Ovarian Reserve Testing

This test determines the quality and quantity of eggs available for ovulation. Imaging techniques and blood tests may be used.

  1. Hysterosalpingography (HSG)

This procedure involves the injection of x-ray contrast fluid in your uterus to check for abnormalities. The test checks the fluid flow from the uterus into the fallopian tubes. If there is a problem, the doctor does further testing.

  1. Laparoscopy 

Laparoscopy is a non-invasive surgery where the doctor uses a laparoscope to view your internal reproductive organs. The doctor inserts the laparoscope through a small incision below the navel to view the uterus, ovaries, and fallopian tubes. This helps diagnose scarring, endometriosis, blockage of tubes, and ovary abnormalities.

  1. Imaging

A doctor uses an ultrasound to check for uterine and fallopian tube infections. 


Benefits of Laparoscopy Procedure in Treating Infertility

  1. Laparoscopies for infertility can be beneficial if you have scarring or blockage in the fallopian tubes. This disease is hard to diagnose and treat using other methods of diagnosis. A laparoscope helps the doctor to view and correct blocked or scarred tubes to enhance conception.

  2. While other methods of diagnosis can identify fibroids and endometriosis, laparoscopy is the only sure method of ascertaining the presence of these abnormalities. Doctors can only diagnose mild endometriosis and scarring in the uterus through laparoscopy.

  3. Pelvic pathologies can go undetected, resulting in recurrent in vitro fertilization failures. Laparoscopy helps detect and treat these abnormalities, increasing the chances of conception.

  4. Removal of pelvic adhesions and endometrial tissue through laparoscopic surgery enhances natural conception. If you have unexplained infertility, a laparoscopy can help you determine its cause.

  5. Laparoscopy is less invasive compared to open surgery. You only take a day to recover, and you can go back to your normal routine within a week. Additionally, it’s less painful and has minimal blood loss since it involves small incisions.


How Laparoscopy is Performed

Like other surgeries, you must fast for 8 hours before surgery. The doctor uses general anesthesia to make you unconscious during the operation.

The surgeon makes a minor incision below the navel using a syringe. The doctor pumps carbon dioxide through the syringe to elevate the abdominal wall from internal organs. 

They insert a laparoscope through the incision when the gas is enough. Checkout the reason for gas problems. The viewing device has a camera connected to an external screen. The connection gives clear and magnified images of the internal organs. 

The doctor uses the screen to view the ovaries, fallopian tubes, and uterus. It’s easy to identify abnormalities such as Scarring, minor endometriosis, pelvic adhesions, cysts, and fibroids in the reproductive system.

The doctor injects a dye from the cervix for a clear view of blockage in the fallopian tubes. The dye also helps detect an ectopic pregnancy.

If the procedure includes surgery, the doctor makes other incisions to allow entry of other clinical tools. The screen guides the doctor on where to direct the tools to the target organ. This procedure can be used for blocked tubes, removing fibroids, scar tissue, cyst, and endometrial tissue.

When the doctor is satisfied, he removes the laparoscope and other instruments. The carbon dioxide is let out through a syringe. Then, he closes the incisions through stitches or clips and applies a dressing. You have to take antibiotics and pain relievers to avoid pain and infections. 


Risks Involved in Laparoscopy Procedure

  1. A laparoscopy for infertility comes with adverse but rare risks. The procedure can result in death in some cases, although the occurrences are rare. According to a study by Roy (2006), out of 100,000 laparoscopic procedures, 3.3 resulted in mortality. 

  2. Bleeding is another risk accompanied by laparoscopic procedures. Incisions made through the abdomen can result in excessive bleeding requiring a transfusion for people with minimal clotting factors. 

  3. Blood clots can occur after a laparoscopy. This prevents proper blood flow, especially in the legs, due to reduced blood pressure hence the chance for blood clots.

  4. Damage to internal structures near the reproductive system can occur during the procedure. Blood vessels, the stomach, bladder, and ureter can be damaged during the insertion of the laparoscope and other surgical tools.

  5. The internal organs can get into the incision resulting in a hernia.

  6. Some people experience adverse reactions to anesthesia.

  7. Abdominal inflammation and infection of the incision.

  8. Damage to the nerves around the incision area.


Common Side Effects 

You can experience the following side effects:

  1. Skin irritation on the incision site

  2. Bladder infection due to urine retention during the procedure

  3. Adhesions 

  4. Infections at the incision site.

  5. Hematomas in the abdominal walls

  6. Bloating due to carbon dioxide.

  7. Muscle pain and tiredness

  8. Mild nausea, pain, and abdominal discomfort

  9. Shoulder pain because of carbon dioxide gas


Results

The results of a laparoscopy done for infertility testing usually show blockages of the fallopian tubes, adhesions, endometriosis, cysts, and fibroids. The doctor can correct these abnormalities during the same procedure. 

If a doctor finds a rare disorder of the organs, further analysis is done, including a biopsy to eliminate serious conditions such as cancer. Results can also indicate a healthy reproductive system, and all you must do is eat a healthy diet, exercise and take some supplements to enhance conception. 


Future Fertility

Future fertility after a laparoscopy depends on the detected cause of infertility. Your physician will direct you on the best cause of action after the results. If your problem is fibroids or blocked tubes, the doctor removes them safely and unblocks the tubes. Then you can try to get pregnant without further intervention.

In the case of endometriosis, removing the scar tissue can make it possible to conceive naturally. Treatment of infections such as PID can also help. 

Other conditions such as PCOS may require additional hormonal treatment to help conception. However, doctors can recommend in vitro fertilization if the fallopian tubes are completely damaged. Whichever solution you settle on, it’s important to wait for at least three months after the procedure before you try to conceive.


Summary 

If you have trouble conceiving, try laparoscopy. It’s a safe and proven procedure to help you become a parent. Misdiagnoses lead to the recurrent treatment of non-existent diseases causing frustrations and stress. Causes of infertility, such as endometriosis, blocked fallopian tubes, and scarred uterus, can only be detected through laparoscopy.  

Doctors have embraced the procedure to diagnose and treat infertility. It gives a clear view of the reproductive organs to help doctors detect abnormalities in the uterus, ovaries, and fallopian tubes. Although it’s easy and non-invasive, it carries some risks, such as bleeding and destruction of internal organs. However, the benefits outweigh the risks.


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