Certain conditions may affect a woman’s chance of achieving a pregnancy and may need to be treated prior to undertaking assisted conception with reproductive surgery. This may include ovarian cysts, endometriosis, hydrosalpinges, endometrial polyps and fibroids. Uterine abnormalities such as polyps, fibroids or uterine septae are diagnosed and treated by means of a hysteroscopy. This is where a small camera is passed through the cervical canal and into the uterine cavity to visualise any abnormalities. Polyps are easy to remove and fibroids require resection. Adhesions can also be removed as can uterine septae.
Ovarian cysts, endometriosis and hydrosalpinges would require a laparoscopy for absolute diagnosis and for treatment. Laparoscopy involves a general anaesthetic and a small camera is passed usually through the belly button to visualise the pelvic cavity. The aim of the surgery is to see, diagnose and treat all at the same time.
Endometriosis is associated with fertility problems, although is not known to be a direct cause. Endometriosis is treated by means of Diathermy and scissor dissection as necessary.
Hydrosalpinges which are swollen fallopian tubes can also be removed by means of laparoscopy. This is called a laparoscopic salpingectomy. Women who have hydrosalpinges visible on ultrasound scan should have the tube removed prior to having any IVF treatment. This does improve success rates of IVF treatment although it is not absolutely necessary to pursue IVF treatment.