After your initial assessment, I might recommend surgery – either to investigate the cause of your infertility, or to treat problems that are making it difficult for you to conceive.
Female fertility surgery
Diagnostic laparoscopy and hysteroscopy
These tests can be important parts of the fertility evaluation for many women, but they are often some of the last ones I will recommend because they are more invasive. They take place under general anaesthetic, and use a small-diameter telescope, which allows me to check your reproductive organs for abnormalities.
In a laparoscopy, small incisions are made at or just below the navel and pubic hairline. I will check your ovaries, fallopian tubes, uterus and pelvic cavity, and I can also check that your fallopian tubes are open by inserting a type of dye through the uterus. A hysteroscopy is a similar procedure that will let me view your uterine cavity for polyps, adhesions or fibroids.
If I suspect that you have endometriosis, I might suggest a laparoscopy to check this diagnosis. I may also remove the endometriosis and any scar tissue at the time of surgery
If we find tubal damage during your laparoscopy, tubal surgery can be used to correct this. Damage or abnormality to the fallopian tubes can affect your chances of success with other fertility treatments.
Male fertility surgery
Male fertility treatment can also include surgery. I may recommend microsurgical procedures (which use an operating microscope) for the repair of the vas deferens, vasectomy reversal, or sperm retrieval.