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Surgically Speaking

Common Procedures to Restore Fertility

By Teri Brown

Fertility treatment has come a long way. Not only do we have hormonal therapies and in vitro fertilization, but there are a host of surgeries also used to enhance a woman's ability to conceive.

Dr. Timothy Hickman is the medical director of Houston IVF and Board Certified Reproductive Endocrinologist/Infertility Specialist at The Methodist Hospital in Houston, Texas. He says the fallopian tube is one of the most delicate tissues in the body.

"Even mild scarring can cause dysfunction and interfere with egg pick up," Dr. Hickman says. "Surgery to remove scar tissue is called tuboplasty. They are typically done through the laparoscope, and their aim is to restore normal pelvic architecture. Roughly 20 percent of couples with infertility have tubal factor. This includes those with blocked tubes and those with damaged tubes."

Tuboplasties are rare because their success rate is low and the risks for complications, including etopic pregnancy, are high. Plus, the success rate for IVF, which bypasses the tubes, is so much higher.

Fallopian tube recanalization is a relatively new X-ray procedure that uses a catheter-like device to reopen the fallopian tubes. It is done on an outpatient basis with very few side affects. During the procedure, a doctor guides a special catheter and wires through the vagina and uterus into the fallopian tubes. He can see what he is doing because of the X-ray pictures on the monitor. This procedure can be done in about an hour. The success of this procedure is largely anecdotal with results depending on the type of blockage present.

The chances of a successful tubal ligation reversal depend on many factors, including the type of tubal ligation originally performed, the age of the woman and the amount of damage sustained to the fallopian tubes during the previous surgery. This microscopic surgery requires only a very small incision and one day in the hospital. A normal fallopian tube is about eight inches long and the chances of pregnancy after tubal ligation are directly related to the length of the tube after the reversal surgery is performed, which is why the amount of damage left from the original surgery is key.

Want to see more?

• Robotic Myomectomy: Could Robotic Surgery Help You Conceive?
• Visiting the Reproductive Endocrinologist: What to Expect the First Time You See the R.E.
• Beyond Blood Tests and Hormone Levels: What to Expect From Invasive Infertility Diagnosis and Treatment
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