Some of the causes of infertility can be managed wholly or to some extend with endoscopic reproductive surgery. Methods of endoscopic surgery in gynaecology are the Hysteroscopic and Laparoscopic Surgery.

Endoscopic surgery is the surgery of choice in reproductive medicine due to the minimization of trauma, decrease in the time of hospitalization, faster recovery and excellent aesthetic result.

Dr Ioanna Tsoumpou has trained extensively in hysteroscopic and laparoscopic surgery and has completed an MSc in Advanced Gynaecological Endoscopy at the University of Surrey in the UK.

Laparoscopy

Laparoscopy is a surgical procedure for investigation and treatment of causes of infertility. It is recommended in the following situations:

  • Diagnostic laparoscopy for investigation of infertility
  • Laparoscopic removal of a non-functional fallopian tube (hydrosalpinx) that is estimated to negatively affect the implantation of the fetus in endometrium
  • Laparoscopic lysis of adhesions that blocks or disrupt the architecture of the reproductive organs
  • Treatment of endometriosis such as removal of endometriotic ovarian cysts (endometioma) or treatment of superficial endometriosis. Especially in cases of endometriosis the surgical treatment requires particular attention so that minimal possible trauma is caused in the reproductive organs and as much healthy ovarian tissue as possible is reserved.
  • Laparoscopic removal of fibroids that could adversely affect fertility.

Hysteroscopy

Hysteroscopy as a method of investigating and treating infertility is suggested in the following cases:

  • Diagnostic hysteroscopy
  • Hysteroscopic lysis of endometrial adhesions
  • Hysteroscopic resection of endometrial polyps
  • Hysteroscopic removal of fibroids that project into the uterine cavity (submucosal fibroids)
  • Hysteroscopic repair of uterine septum

Endoscopic surgery can be the only intervention needed for treating infertility in correctly chosen cases. It can also act as an adjunct prior to IVF by increasing the chances of achieving a pregnancy. Therefore the selection of women who will take benefit from endoscopic surgery needs to be done with considerable attention.