Reproductive Surgery

When Is Fertility Surgery Recommended?

Many fertility conditions are treated using medications or assisted reproductive techniques, such as in vitro fertilization (IVF) or intrauterine insemination (IUI). However, sometimes the cause of infertility is an anatomical abnormality that prevents the ovaries, fallopian tubes, and/or uterus from functioning properly. Reproductive surgery can address these anatomical abnormalities and potentially restore reproductive function.

Common Reproductive Surgical Procedures

Going through reproductive surgery can feel very intimidating. The fertility doctors of Indiana Fertility Institute understand the many emotions and challenges that come up when making decisions about fertility care and are dedicated to guiding you through all your options to make sure you’re making the best choice for your family-building needs. Not only will they help you understand the advantages of these procedures, but they will also walk you through everything you need to know and address all of your concerns.

Dr. Jarrett and Dr. Provost are experienced and trained to perform the following pelvic or reproductive surgeries, based on your diagnosis.

1. Endometriosis Treatments

   Endometriosis is a reproductive condition in which endometrial tissue (i.e., the tissue that lines the walls of the uterus) grows in other parts of the body, most commonly in the fallopian tubes, ovaries, pelvic region, and abdominal area. Endometriosis is thought to affect about 10% of women and girls across the globe. Although common, endometriosis is not always easy to diagnose. Symptoms can vary widely from patient to patient. Furthermore, the severity of symptoms (or lack thereof) is not always an accurate indicator of how severe the growth of the endometrial tissue is. The most common signs of endometriosis include painful periods, pain during intercourse, pelvic pain, and painful bowel movements. Endometriosis can also cause infertility. When it comes to treating endometriosis and/or endometriosis-related infertility, recommended procedures can include prescription medications, hormonal therapy, and surgery.

2. Removal of Scar Tissue

   Fertility issues in women can sometimes be caused by a build-up of scar tissue near the ovaries or in the fallopian tubes. If scar tissue develops close to the ovaries, it can prevent the ovaries from successfully releasing eggs. If scar tissue develops in the fallopian tubes, it can obstruct the egg’s path. In some extreme cases, scar tissue formation can lead to adhesion, which is when tissues or organs inside the body become stuck together by a band of scar tissue. Depending on the severity of the scar tissue, surgery may be recommended to help relieve the obstruction.

3. Uterine Abnormalities

   Infertility is sometimes caused by congenital uterine abnormalities. These abnormalities occur in the female reproductive system during fetal development. It’s not uncommon for women to not be aware of uterine abnormalities, as there may not be any symptoms. However, some women do experience signs of uterine abnormalities such as no periods, recurrent pregnancy loss, and pelvic pain. Many women do not find out they have a uterine abnormality until they undergo an ultrasound. Uterine abnormalities come in many forms. The most common type is known as a septate uterus, in which the uterus has a normal shape and external structure but has an internal wall of tissue that divides the womb into two cavities. The process of correcting this anatomical issue is usually done through a hysteroscopic surgical procedure.

4. Management of Abnormal Uterine Bleeding

   Abnormal uterine bleeding, also known as dysfunctional uterine bleeding (DUB), can often be seen as a sign of fertility issues. DUB is often caused by underlying reproductive conditions such as polycystic ovarian syndrome (PCOS), endometriosis, uterine fibroids, uterine polyps, inflammatory sexually transmitted diseases (e.g., chlamydia, gonorrhea), and cancer. Treatments for DUB can include hormone therapy or hysteroscopic surgery. Common symptoms of DUB include:

   • Irregular bleeding between periods
   • Heavy menstrual bleeding
   • The presence of several or large clots in menstrual blood
   • Bleeding that lasts longer than a week
   • Bleeding that occurs outside of the normal window of a menstruation cycle

5. Ovarian Cystectomy

   Fertility issues are sometimes caused by ovarian cysts, which are sac-like growths filled with fluid or other membranous solids that develop on the surface of or inside an ovary. Ovarian cysts are very common and generally don’t cause any issues. In many cases, they go away without medical intervention. However, when ovarian cysts are associated with other reproductive conditions such as endometriosis or PCOS, they can lead to or exacerbate infertility. In these scenarios, laparoscopic surgery may be recommended to remove the problematic cysts.

6. Tuboplasty

   Infertility is sometimes caused by functional or structural problems in the fallopian tubes. The fallopian tubes are where the sperm and the egg meet each other for fertilization. If there is scar tissue or an obstruction present in the fallopian tubes, it can prevent fertilization from occurring. These types of tubal issues may be caused by an underlying condition, such as endometriosis or pelvic infection. A tuboplasty is a procedure that can help restore the structural integrity and functionality of the affected fallopian tube.

7. Myomectomy for Fibroids

   Fibroids are a type of tumor that grows in the uterus’s muscular tissue. They are generally non-cancerous but can cause infertility and other reproductive issues, including recurrent pregnancy loss. A myomectomy is a surgical procedure in which the fibroids are removed, leaving the uterus intact. This procedure can be performed through hysteroscopic or laparoscopic surgery.