Infertility surgery

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2] Associate Editor(s)-in-Chief: Sanjana Nethagani, M.B.B.S.[3]

Ovarian surgery[edit | edit source]

• Laparoscopic ovarian drilling is done by performing multiple punctures in ovarian cysts by diathermy or laser. The main aim of this procedure is to reduce androgen levels and promote ovulation. This procedure might be pursued in clomiphene resistant women who also had hyperandrogemeia ^[1][2]
• Wedge resection is another therapy in PCOS when clomiphene therapy fails.
• Abdominal surgery to remove any virilizing tumors of the ovary or adrenal glands.

Tubal surgery[edit | edit source]

• Salpingoovariolysis is done for peritubal adhesions.^[3]
• Tubal block due to mucus plugging or any other reason can be corrected with salpingography or balloon tuboplasty.
• Distal tubal blocks such as fimbrial adhesions or fimbrial phimosis are treated with fimbrioplasty.
• Neosalpingotomy is the creation of a new tubal opening when a tubal block cannot be corrected.
• Mid-tubal block seen in surgical sterilization can be reversed to achieve fertility. How successful the surgery is in reversing the block depends on the method of sterilization, age of the patient, site of anastamosis and length of reconstructed tube. ^[3]
• Microsurgical procedures have the best results due to minimal scarring post surgery.
• Poor outcomes in tubal surgery are seen with dense adhesions, bilateral hydrosalpinx, advanced age, loss of fimbriae, short length of tube after reconstruction etc.

Uterovaginal surgery[edit | edit source]

• Submucosal fibroids causing infertility can be corrected with myomectomy. Adhesions may be a complication post myometcomy.^[4]
• Uterine septum removal or unification of a congenital septate uterus is done with metroplasty. ^[5]
• Hysteroscopic adhesiolysis is done in uterine synechiae.
• Hysteroscopic polypectomy is done to treat endometrial polyps.

References[edit | edit source]

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