Conditions causing infertility that may be treated surgically
Uterine fibroids are noncancerous growths of the uterus that develop during the reproductive life of a woman. Although uterine fibroids aren’t associated with an increased risk of uterine cancer and almost never develop into cancer, they can be a painful condition and also result in infertility.
Uterine fibroids are characterized by heavy menstrual bleeding, prolonged periods, pelvic pain, frequent urination, difficulty in emptying the bladder, and backache amongst other things. Causes associated with fibroids would be genetic and hormonal.
Uterine anomalies are also known as Müllerian anomalies and refer to the various defects of the vagina, cervix, uterus, or fallopian tubes present from the time of birth. The presence of such defects can cause infertility and will require surgical correction. There are several different forms of Mullerian anomalies ranging from the absence of a uterus to the formation of a half uterus or a double uterus to a uterus divided by a septum.
Fallopian Tube Blockage
Fallopian tubes connect the ovaries and uterus and are an integral part of the reproductive tract that allows for the transfer of the oocytes from the ovaries to the uterus. In some cases, a woman may have either damaged or blocked fallopian tubes that can disrupt the transfer of the oocytes or block the passage of the sperm – thereby causing infertility or difficulty in implantation.
The recourse to such blockage is a surgical repair/reopening of the damaged/blocked tubes and aid fertility. In some cases, the damage to the fallopian tubes is the cause of ectopic pregnancies.
Ovarian cysts are sacs filled with fluid that form in or upon the ovaries; eventually, most of these go away on their own but some of them can end up interfering with the woman’s reproductive cycle and fertility. This is particularly true in the case of polycystic ovary syndrome (PCOS). PCOS will result in infrequent or prolonged menstrual periods or excess male hormone (androgen) levels.
As such PCOS is not treated with surgery, however minimally invasive techniques provide a better view of the internal structures and diagnose ovarian cysts. A procedure known as cystectomy may be performed for the removal of ovarian cysts.
Endometriosis is a chronic condition of the uterus wherein the lining of the uterus, known as the endometrium, begins to grow outside of the uterus. This can result in pain and infertility while also adversely affecting the reproductive organs. Symptoms associated with endometriosis include – painful periods, painful intercourse, painful urination, excessive bleeding amongst others.
Causes of the condition are retrograde menstruation, disorders of the immune system, surgical complications, and others. Laparoscopy is one of the best ways of treating endometriosis.
Pelvic adhesions to a condition wherein the pelvic are stuck or adhered together. This could be adhesion of the fallopian tubes or the ovaries being stuck to the walls of the abdomen and others. This disrupts the reproductive cycle, with the release, transportation and implantation being affected by the respective adhesion. This can be corrected with minimally invasive surgical procedures wherein the surgeon will restore the respective organ to its normal position and thereby increase the chances of implantation, conception, and pregnancy. The underlying causes of pelvic adhesions have been identified as endometriosis, previous pelvic infection, and previous surgeries in the pelvic area.
Asherman’s syndrome is similar to pelvic adhesions, except that the adhesions occur inside the uterine cavity. Common causes of the condition include – previous surgical interventions of the uterine cavity. A surgical hysteroscopy is an excellent way to correct Asherman’s syndrome. In the post-operative phase, a higher dose of oestrogen is prescribed to help the uterus lining, or the endometrium, grow over the area where the scar tissue has been cut away.
A uterine septum refers to an extra wedge of tissue that hangs from the top of the uterine cavity and divides the cavity into two, it can be either short or long extending upto the cervix.. And this results in failure of pregnancy should the embryo get implanted in the said region. The septum can occur in various sizes and may at times cover the entire uterus. The treatment for this disorder is to remove the septum with a surgical hysteroscopy.