Laparoscopy for Infertility

Throughout the blog, we will cover the following topics:

• What is Laparoscopy?
• Purpose
• Preparation
• Procedure for Laparoscopy
• Pelvic Laparoscopy
• Gynaecologic Laparoscopy
• Laparoscopy for Infertility
• Risk Associated with Laparoscopy
• Benefits of Laparoscopy
• How long does it take to recover?
• How can Medicover Fertility help you?
• What is Laparoscopy for Infertility?
• Is Laparoscopy Painful?
• Does Laparoscopy Help with Infertility?
• Why Laparoscopy is Done for Infertility?

What is Laparoscopy?

Laparoscopy means simply a type of operative procedure that uses a thin tool called a ‘Laparoscope’. It is most commonly used to diagnose any abnormality in organs inside the abdominal cavity, hence is also known as diagnostic laparoscopy. The name Laparoscopy comes from the name of the instrument laparoscope used to perform the procedure. The main purpose of performing this surgery is to examine the abdomen organs with minimal incision in the body.

The laparoscope is a long and thin instrument which has a high-resolution camera and a high-intensity light mounted on the front end. A small incision (0.5-1cm) is made into the body, and the laparoscope is passed through it. The camera then sends data in the form of images and videos to the video monitor. In the conventional method, the doctor had to make a larger incision in the body to examine the internal organs with their eyes. However, with a laparoscope, the same could be done with a much smaller incision are easily examined with the help of the camera. Moreover, the image feed could be recorded for future references. Apart from that, biopsy samples could also be taken from the body with this method.

Laparoscopic surgery could be used for gastro operations, gynaecology surgery or a gallbladder surgery as well. This procedure involves very less risk and considerably more effective than the manual method.

Purpose

The main purpose of using Laparoscopic Surgery is to examine the problems in the abdominal region. In most cases, it is performed when the patient has some conditions in the abdominal or pelvic region. Although there are other non-invasive methods present to investigate the reason for such problems like an ultrasound or sonography, an MRI scan and a CT scan. When an inner organ needs to be diagnosed, laparoscopic surgery is used so that the situation becomes clear enough for the doctor to start applicable medical treatment for the same.

Laparoscopy could be recommended by the doctor to examine the following organs:

• Liver
• Stomach
• Spleen
• Intestines
• Pancreas
• Appendix
• Reproductive organs
• Gall bladder

Apart from examining the above organs, laparoscopy can also be used to take a sample of tissue from an organ or to take biopsy samples.

The diagnosis performed can help to detect and treat liver diseases, fluids in the abdominal cavity, a tumour or cancer and the result of certain treatments. It can help to start relevant medical treatment. Laparoscopy can also be used to remove cysts from ovary or to treat hydrosalpinx (accumulation of fluids in tubes). Fibroids in the uterus can also be removed using laparoscopy.

Preparation

The preparation for laparoscopic surgery is much like any other surgery. Before the operation, the doctor may ask for some common tests to be done, such as blood test, urine analysis, ECG, etc. Apart from these tests, imaging tests could also be done like ultrasound, chest X-ray, MRI scan or a CT scan. These tests give vital information about your body’s status and help the doctors in understanding the problem a little better.

Medications that affect the result of the surgery are altered or stopped a day or two before the surgery. Thus, it is advisable to share your medical history and current presc.ription with the doctor so that the doctor takes suitable measures. Common types of such medicines are inflammatory drugs like aspirin, ibuprofen, etc., blood-thinning drugs, Vitamin K and dietary supplements. The doctor will guide you the proper dosage and the timing of taking these medicines both before and after the surgery. Also, if you are pregnant or about to get pregnant, you must share this information with the doctor so that preventive measures could be taken for the procedure.

Any medical condition should be shared with the doctor so that the risks of the procedure could be minimised and to ensure the operation is successful.

Procedure for Laparoscopy

Laparoscopy is a straightforward procedure which involves minimal incision into the patient’s body. While preparing for the surgery, you may be given general anaesthesia. The main idea behind the laparoscopic surgery is that there shouldn’t be any long incision, and the purpose of diagnosis be solved. The surgery is not a major one, so it could easily be performed in a hospital as a day-care procedure.

During a laparoscopy, the surgeon makes a cut on the abdomen. Depending on the position and need, 2-3 incisions are made. Each of these incisions is 0.5 to 1 cm wide only. Due to this fact, this surgery is also called a ‘Keyhole Surgery’.

A tube is inserted through the opening of the cut made. This tube is called ‘cannula’. The cannula has multiple functions. It can be used to insert the laparoscope and other surgical instruments into the body also; it can be used to put carbon dioxide in the body to inflate the abdomen. The carbon dioxide gas inflates the abdomen and aids the surgeon in visualizing the organs more clearly.

The camera on the laparoscope is used to view the insides and the organs for any problem. The surgeon then inserts surgical instruments through the tube to perform the further operation. In a biopsy, a sample of tissue from the organs is taken out with the help of surgical instruments for evaluation.

In short, a complete laparoscopic procedure involves:

• Pre-operative check-up based on past medical history and some common investigations include haemoglobin test, blood test, TSH, ECG etc. depending on person-to-person.
• General anaesthesia.
• Pneumoperitoneum, which is the insufflation of carbon-di-oxide gas in the peritoneal cavity for the clear view of organs.
• Laparoscopic insertion and visualisation of organs.
• And finally, the diagnosis and treatment of the cause.

An uncomplicated diagnostic laparoscopy takes as much as 30-60 minutes.

When the laparoscope or other instruments are removed, a special gas valve is left in place briefly to allow all the carbon-di-oxide to escape from the abdomen. The keyhole incisions are then closed.

After the surgery, the patient is monitored in the recovery area. Most patients are released within a few hours of the procedure.

Pelvic Laparoscopy

Pelvic laparoscopy is done mainly to examine the pelvic or reproductive organs of the patient. These include investigating or treating the organs such as the fallopian tube, the uterus, the bladder and other reproductive organs. Pelvic laparoscopy can be done to:

• See the shape, size of uterus and ovary and to diagnose any abnormality.
• Diagnose conditions that are preventing fertility
• Detect the cause of any pain in the pelvic region
• Examine the fallopian tube for any blockage, or any fluid collection in the tube and treat at the same sitting.
• Investigate or confirm the presence of any abnormality found in other imaging studies like a tumour, ovarian cyst, or a tissue mass
• Confirm the presence of and determine the extent of growth of various types or pelvic cancers such as cervical cancer, endometrial cancer or ovarian cancer
• Examine the pelvic region for any possible causes of ectopic pregnancy
• Diagnose for any diseases in the pelvic region
• Determine the presence of endometriosis

The doctor may recommend pelvic surgery to treat some conditions related to fertility also.

Gynaecologic Laparoscopy

The gynecologic laparoscopy is much like the pelvic laparoscopy. It is also used to determine the problems in the pelvic region, but it extends to do the treatment on them too with minor surgeries. The doctor recommends gynecologic laparoscopy in cases where the patient is experiencing pain in the pelvic region, there is or has been an infection in the reproductive organs or to determine the cause of infertility. This kind of laparoscopy is thus also known as laparoscopic surgery for infertility.

As said previously, gynecologic laparoscopy can be used to diagnose and treat problems related to the reproductive organs. There are many conditions that this surgery can diagnose such as:

• Infertility laparoscopy
• Ectopic pregnancy in which the fertilized eggs implants other than the uterus
• Different kinds of cancers in the reproductive organs
• Tumours or ovarian cysts
• Benign tumours in the uterus or uterine fibroids
• Scar tissues that pain
• A condition called endometriosis in which uterus lining cells grow outside the uterine cavity
• Pus or other fluids in the pelvic organs
• Inflammatory diseases of the reproductive organs
• Other pelvic problems

The gynaecologic laparoscopic surgery is implemented to treat the following kinds of problems such as:

• Removing the tumours
• Removing the fibroids or the ovarian cysts
• Removing any contraceptive treatment called tubal litigation
• Removal of painful scar tissues
• Treating the endometriosis
• Removing the ovaries
• Removing the uterus

While a gynaecological laparoscopy is an easier and effective procedure, it is still not applicable to everyone. Sometimes the surgeon may suggest for another investigative procedure to understand the problem. There are some common conditions under which gynaecological laparoscopy is not suitable like if the patient has some serious heart or lung condition.

It is possible to get the analysis of the problem to a certain extent with the help of imaging tests like ultrasound, CT scan, etc. It can give the doctor an idea of what might be the problem and the target area. As an alternative, the doctor may suggest some form of medication or some hormonal treatment.

A surgical alternative to laparoscopy is laparotomy, which is a similar kind of procedure. Instead of making smaller incisions as in laparoscopy, a large incision is made into the abdomen. In certain cases, like when the patient is bleeding in excess (an emergency condition), laparotomy is suitable. Still, laparoscopy is a better choice most of the times. You can discuss this with your doctor and get a better idea of your situation.

Laparoscopy for Infertility

There could be certain issues in any of the reproductive organs, right from the uterus, the tubes, and the ovaries. So, after a simple diagnosis and fixation of the problems, women have a high chance of conceiving after laparoscopy.

Some of the cases where laparoscopy is used as a procedure to help treat infertility are:

1. Within the uterus, first of all, if there are uterine fibroids where embryo needs to be implanted or where the baby has to fix itself, it needs to be corrected using laparoscopic procedures.
2. Sometimes, the uterus itself may be abnormally shaped, or it may be a bi-cornuate uterus. It may not allow a woman to conceive. It may also be a septum, i.e. a division within the uterine walls that hinders a pregnancy or even leads to miscarriage. So, to remove this, laparoscopy is done to help women conceive.
3. The fallopian tubes that are blocked are opened using laparoscopic surgery. After the removal of such obstruction, the conception chances of women considerably increase.
4. Sometimes the tube itself may be damaged, and unhealthy called Hydrosalpinx. It is a condition of abnormal fluid collection in the fallopian tubes. In that case it has to be clipped, using laparoscopic surgery and only then an IVF procedure is proceeded with.
5. In cases where the ovaries are not functioning well, or if they are having cysts, it can be treated with medication. But if they are large and persisting, they need to be treated by laparoscopy.
6. In women suffering from endometriosis, the uterus, the tubes, the ovaries, all get stuck up together in many cases. So, normal functioning is affected. By releasing the adhesions between them through laparoscopy, they get back to their normal functioning and again enhance the chances of fertilization.

Laparoscopic procedures are used for both diagnostic laparoscopy for fertility as well as to treat several minor infertility issues and other mild medical complications. Sometimes, even minor laparoscopic surgery for infertility with IUI can help a woman conceive, and in some cases with severe infertility, laparoscopic surgery followed by IVF is considered to be the best treatment option to help couples conceive a pregnancy.

Moreover, the laparoscopy for infertility success rate and laparoscopy for infertility cost in India varies from place to place and person-to-person, based on the patient's past medical history, the type of treatment opted, and risks associated.

Risk Associated with Laparoscopy

Laparoscopy is minimal risk and less complicated kind of surgery. There are fewer risks associated with it. Still, there are some risks that are present. The most common risks that can be said to have been related to laparoscopic surgery are infection, bleeding, or any damage to abdominal organs, etc. These risks occur rarely. It is important to note these signs and consider them as potential risks.

There are some side effects of laparoscopy for infertility. These are rare but could happen. You may experience:

• Pain in the abdominal region
• Bleeding at the incisions
• Swelling or redness at the cuts
• Difficulty in breathing and cough
• Unexpected blood clots
• Complications due to anaesthesia

These effects are normal if they happen for just a few days. However, if they are prolonged or more intense, you must consult your doctor immediately.

Although, the risk of your organs getting damaged after the surgery is very less, it may happen in some cases. Sometimes, blood or pus may come out of the incisions from your body. In such a case, immediately seek medical attention; you may also need to have another surgery to treat such a condition.

In some rare cases, where the patient already had some kind of abdominal surgery, the risk of organs getting damaged due to laparoscopy increases, especially the risks of development of adhesions between abdominal structures increases.

Benefits of Laparoscopy

In the conventional method for the diagnosis of abdominal organs, the surgeon had to make long incisions. These incisions were more susceptible to bleeding, getting infected and would take a long time to heal. However, with laparoscopic surgery, you get several advantages, such as:

• The incisions are smaller
• Less internal scarring
• The cuts don’t pain much and take a shorter time to heal
• You get to leave the hospital much quicker
• The incisions heal quickly so you don’t have to wait long; you can resume your work much early.

If you compare the two methods with general data, in most cases, you will find that a person with traditional surgery may need to rest for a month or two to recover completely. While in the laparoscopic method, he may leave the hospital on the same day and will recover in 1 week. It also saves your costs by a substantial amount.

How long does it take to recover?

Laparoscopy for infertility recovery time is based on the minimal invasion technique. Due to the smaller incisions, they heal quickly, and the patient thus recovers in a shorter time. However, the amount of time after which you can be discharged from the hospital is not same for everyone, and it depends on the following factors such as:

• The number of incisions made
• The type of anaesthesia administered
• The body’s response to the surgery
• The overall health of the person

After laparoscopy, the patient is observed by the doctors for a few hours before getting released. The body’s response is checked; the vital signs are monitored carefully. To observe any adverse effects, the patient is also observed for any unnatural or prolonged bleeding. Also, the doctors observe for any harmful effects of anaesthesia. The procedure may leave you a little weak, which is normal; however, the hospital staff will check you for any adverse effects. When the observation period is over, the patient feels better, he or she can go home.

When at home after the surgery, it is advisable to rest and don’t do strenuous work at all. The patient may feel some pain in the places where incisions are made, which is normal. The pain should lose intensity over the coming days, and it could also be reduced with the help of some medication prescribed by your doctor.

In many cases, carbon dioxide gas is used to inflate the abdomen, which helps during the surgery. This gas disturbs the diaphragm and can cause pain in the shoulders. Such pain and discomfort are also normal and should go away in two to three days.

Although the laparoscopy recovery doesn’t take much time, it is better to follow the instructions of the doctor to ensure a smooth recovery. To do that, you should:

• Wear loose fitted and comfortable clothes
• Don’t do any strenuous work which causes incisions to open
• Complete rest a for a few days
• Have only doctor prescribed medication
• Begin some light work after a week or so

In a week or two, you can begin some normal activities. All the while, it is important to note any problematic signs and tell them to your doctor. You must take a follow-up consultation with the doctor a couple of weeks after the surgery.

How can Medicover Fertility help you?

Laparoscopy is not a major surgery, but it should not be taken lightly. Especially in the case where you are getting a Pelvic Laparoscopy or Gynecologic Laparoscopy, you must never take a risk. Medicover Fertility is a renowned name in fertility treatment. We have the latest technologies and treatment techniques as well as experienced doctors who can handle any issue related to infertility treatment. If there is a need for laparoscopy, you should get consultation and treatment from Medicover Fertility. We are here to help and support you to the best of our extent to help you realize your dream of a child. Contact us at +917862800700.

FAQs

Q – What is Laparoscopy for Infertility?

A – Laparoscopy for infertility is the procedure of laparoscopy done to provide treatment for infertility.

Q – Is Laparoscopy Painful?

A – Laparoscopy is not painful. The general anaesthesia given will make you sleep, and you won’t feel the pain. The holes or cuts which are made in the surgery are very small, so they don’t hurt. In fact, you can go to your home the very same day or next day. Taking into consideration laparoscopy for infertility recovery time, just a few days rest will be enough for the cuts to heal.

Q – Does Laparoscopy Help with Infertility?

A – Yes! A laparoscopic surgery can treat some causes of infertility, allowing you a better chance at getting pregnant, either naturally, or sometimes with IUI or IVF.

Q – Why Laparoscopy is Done for Infertility?

A – A laparoscopy allows the doctors to see what’s inside your abdomen and visualise if there’s any suspicious growths or cysts. As a part of fertility testing and an operative measure, laparoscopy is an aid to the treatment of infertility and helping couples conceive.

References:

https://www.emedicinehealth.com/laparoscopy/article_em.htm
https://www.medicalnewstoday.com/articles/308285.php
https://www.healthdirect.gov.au/laparoscopy
https://www.fascrs.org/patients/disease-condition/laparoscopic-surgery-what-it
http://www.csh.org.tw/dr.tcj/educartion/f/web/Laparoscopy/index.htm