In certain cases of infertility, surgery is required, either as a diagnostic and/or a therapeutic tool, to ensure a couple’s best chance for a successful pregnancy. Infertility may occur in both males and females and surgical options may be required for both. Treatment of infertility by surgical means is more common now than ever before, thanks to the great advancements made in medical technology, like Endoscopy.
Female Surgical Options :
- Laparoscopy : A day care surgical procedure which uses a small, fibre optic telescope inserted through an incision near the belly button (navel). The telescope then looks for and removes if required, pathologies like- adhesions in the pelvic cavity, ovarian cysts ,repair of a fluid-filled hydrosalpinx, ovarian endometrioma, uterosacral endometriosis, uterine fibroids etc.
- Hysteroscopy : Outpatient procedure that inserts a very small (diameter) fibre optic telescope into the uterus and cervix through the vagina.Through the hysteroscope, one can then seek out and remove adhesions in the uterine cavity to treat a septate uterus, perform hysteroscopic metroplasty, remove a submucous fibroid, do a polypectomy, etc.
- Reanastomosis (fallopian tube sterilisation reversal) : Reanastomosis connects the two previously disconnected ends of the fallopian tubes in order to reverse the sterilization, thus, opening the Fallopian tubes and helping conception.
Methods of surgical sperm retrieval
The main methods of surgical sperm retrieval available include:
- PESA : percutaneous epididymal sperm aspiration.
- MESA : microsurgical epididymal sperm aspiration.
- TESA : testicular sperm aspiration. This includes testicular fine needle aspiration (TFNA)
- TESE : Testicular sperm extraction.
- Microdissection TESE : Testicular sperm extraction under microscopic vision using a very fine instrument.
- Perc biopsy : percutaneous biopsy of the testis.
Vasectomy reversal : Often performed as an outpatient procedure. A vasectomy reversal is done, wherein, the cut ends of the vas are rejoined to restore the male’s ability to release sperm from the testicles into the semen