About Fertility Restoration Surgery
Fertility restoration surgery aims to correct structural issues causing infertility in men or women. Some conditions that can be addressed through surgery include endometriosis, fibroids, polyps, and other reproductive organ problems.
What is Fertility Restoration Surgery?
Fertility restoration surgery aims to correct structural issues causing infertility in both men and women. These surgical procedures address conditions such as endometriosis, fibroids, polyps, and other reproductive organ problems. For women, fertility restoration surgery may involve tubal ligation reversal, removal of fibroids or cysts, or repair of damaged fallopian tubes. In men, vasectomy reversal or treatment for varicoceles are common interventions. The specific approach depends on the underlying issue and individual circumstances. Consulting with a fertility specialist is crucial to determine the most suitable treatment path. The goal is to enhance fertility and provide hope for those seeking to build a family.
Female Fertility Restoration Surgery
Female fertility restoration surgery aims to address structural issues that may hinder conception. While surgical fertility treatments are less common today due to the success of other approaches, they remain relevant in specific cases. Here are some surgical options:
Tubal Ligation Reversal: This procedure is suitable for women who have previously undergone tubal ligation (having their fallopian tubes tied or cauterized). Laparoscopic or hysteroscopic surgery can restore fertility by reconnecting the fallopian tubes.
Uterine Transplant: Uterine transplant surgery is a groundbreaking option for women born without a uterus or those who have had their uterus removed due to benign or cancerous conditions. A successful transplant can offer hope for fertility and a chance to carry a pregnancy.
Ovarian Cystectomy: A laparoscopic surgery to remove cysts from the ovaries. It helps preserve ovarian function and fertility.
Endometriosis Excision: Surgical removal of endometriosis lesions, which can affect fertility. Excision aims to improve reproductive outcomes.
Hysteroscopic Procedures: These involve examining and treating the uterine cavity. Examples include removing polyps, fibroids, or scar tissue.
Laparoscopy: Minimally invasive surgery to assess fallopian tubes, ovaries, and uterus. It identifies conditions like endometriosis, adhesions, or tubal blockages.
Female infertility conditions treated by surgery
Endometriosis: Endometriosis is an often-painful condition where tissue similar to the inner lining of the uterus grows outside the uterus. It commonly affects the ovaries, fallopian tubes, and the tissue lining the pelvis. Endometriosis can lead to symptoms such as painful periods (dysmenorrhea), pain during or after sex, discomfort with bowel movements or urination, and excessive bleeding. It may also contribute to infertility.
Fallopian tube blockage: Fallopian tube blockage occurs when the tubes connecting the ovaries and the uterus are obstructed. These tubes play a crucial role in fertility, as they transport eggs for fertilization. Common causes of blockage include scar tissue, pelvic inflammatory disease, endometriosis, and past surgeries. While blocked tubes can lead to infertility, treatments such as surgery or in vitro fertilization (IVF) may offer hope for conception.
Uterine fibroids: Uterine fibroids, also known as leiomyomas or simply fibroids, are common growths of the uterus. These benign tumors consist of smooth muscle cells, fibroblasts, and other materials. While some women with fibroids experience no symptoms, others may have heavy or painful periods, pelvic pressure, frequent urination, or pain during sex.
Uterine polyps: Uterine polyps, also known as endometrial polyps, are small, soft growths attached to the inner wall of the uterus (endometrium). They can range in size from a few millimeters (no larger than a sesame seed) to several centimeters (golf-ball-size or larger). These polyps may have a large flat base or be attached by a thin stalk. While most uterine polyps are noncancerous (benign), some can be cancerous or precancerous.
Pelvic adhesions: Pelvic adhesions are fibrous bands of scar tissue that form between pelvic organs and tissues, causing them to stick together. These adhesions can result from various causes, including previous surgery, infection, inflammation, or endometriosis. They may lead to pain, infertility, and bowel or bladder dysfunction.
Polycystic ovary syndrome: Polycystic ovary syndrome (PCOS) is a common hormonal disorder affecting women during their reproductive years. It is characterized by irregular menstrual periods, excess hair growth (hirsutism), acne, and sometimes infertility. The underlying cause is an imbalance of androgens (male hormones). Women with PCOS may have small fluid-filled cysts in their ovaries, which can lead to irregular ovulation.
Egg retrieval: Egg retrieval is a crucial step in in vitro fertilization (IVF). During this procedure, mature eggs (oocytes) are surgically extracted from a woman's ovaries. These retrieved eggs are then combined with the male partner's sperm in a laboratory setting to form embryos. Egg retrieval plays a pivotal role in helping individuals and couples overcome infertility challenges.
Male Fertility Restoration Surgery
Male fertility restoration surgery encompasses various procedures aimed at addressing structural issues that may hinder sperm production, maturation, or delivery. Here are some surgical options:
Vasectomy Reversal: This procedure is for men who have previously undergone a vasectomy. During a vasectomy reversal, the surgeon reconnects the vas deferens (the tubes that carry sperm from the testicles). Successful reversal allows sperm to be present in the semen again, potentially restoring fertility.
Varicocelectomy: A varicocele is an enlarged vein within the scrotum that can affect sperm production. Varicocelectomy involves surgically repairing or removing the affected veins to improve sperm quality.
Epididymal or Vasal Obstruction Correction: Microsurgical techniques can correct blockages in the epididymis (where sperm mature) or the vas deferens (which transports sperm). Clearing these obstructions enhances sperm delivery.
Ejaculatory Obstruction Correction: Endoscopic procedures can address issues with the ejaculatory ducts, ensuring proper semen flow during ejaculation.
Male infertility conditions treated by surgery
Sperm duct microsurgery: Sperm duct microsurgery, also known as vasoepididymostomy, is a specialized procedure for treating epididymal obstruction in male infertility. The advantages of these microsurgeries include the ability to father biological children through natural intercourse, and lower overall costs per live baby compared to IVF.
Epididymovasostomy: Epididymovasostomy, also known as vasoepididymostomy, is a surgical procedure used to reverse a vasectomy. During this complex intervention, the vas deferens (the tube that carries sperm) are directly connected to the epididymis (a small organ at the back of the testicle that holds sperm). Epididymovasostomy aims to restore fertility for individuals who previously underwent a vasectomy.
How is Fertility Restoration Surgery performed?
Fertility restoration surgery varies depending on the specific condition being addressed. Let's explore some common procedures:
Vasectomy Reversal: This is done to restore continuity of the male reproductive tract after a vasectomy. During this, the surgeon locates the vas deferens (sperm-carrying tubes) on each side. The vas deferens are reconnected microscopically using sutures. Scar tissue from the original vasectomy is removed. Sperm returns to the ejaculate, and natural conception becomes possible.
Tubal Ligation Reversal (for women): This is done to restore fertility after fallopian tubes have been tied or cauterized. The procedure is typically laparoscopic with robotic assistance. During this, the surgeon makes small incisions in the abdomen. The tubes are carefully reconnected. Scar tissue is excised. Which, allows natural conception by restoring tubal function.
Endometriosis Excision (for women): This is done to remove endometriosis lesions causing pain and infertility. Tiny incisions are made, and recovery time is usually two weeks. The surgeon excises endometriosis tissue. The results are long-lasting pain relief and improved fertility result.
Fallopian Tube Recanalization: This is done to clear blockages in fallopian tubes—no incisions; done through the cervix. Contrast liquid was injected to visualize blockage. X-ray guides the procedure. This will restore tubal patency.
