Women who can’t get pregnant due to problems with their uterus, ovaries, or fallopian tubes often need reproductive surgery to correct the condition and restore their fertility. As an experienced reproductive endocrinologist and skilled surgeon, Fangyin Meng, MD, PhD, has helped many women at her practice in Newport Beach, California, overcome infertility with advanced surgery.
Here’s what you need to know about the conditions that often cause infertility and the types of reproductive surgery we perform.
Gynecological causes of infertility
A variety of issues can lead to fertility problems in women, but here are some of the top causes:
Polycystic ovary syndrome
Ovulation problems are the top cause of female infertility. Several health conditions may stop your ovaries from releasing an egg, but a common one is polycystic ovary syndrome (PCOS).
PCOS develops when you have unusually high levels of androgens. Androgens are male hormones that women have in tiny amounts. It only takes a small increase in androgens to have a serious impact on your ovaries. High androgen levels can interfere with egg maturation and ovulation and cause irregular or missed periods.
Uterine fibroids usually grow in the muscular wall inside the uterus. Though not as common, these masses can also develop inside the uterine cavity or on the outer wall of the uterus. Fibroids are typically benign, but they can grow large enough to cause infertility.
As the masses enlarge, they may change the shape of your uterus or block the fallopian tubes. They may also affect the inner lining of your uterus, preventing a fertilized egg from implanting.
Endometriosis is a gynecological condition in which endometrial tissue — which normally lines the inside of the uterus — starts growing outside of the uterus, such as on the ovaries, fallopian tubes, and other nearby organs.
Experts aren’t certain what causes endometriosis, but they do know the effects it has. Even though this tissue grows outside the uterus, it still behaves like it’s in the uterus.
These patches of endometrial tissue respond to the hormones that regulate your monthly menstrual cycles. As a result, they thicken and bleed into the pelvic cavity just as you bleed during your menstrual period. This bleeding can cause scarring, chronic inflammation, and adhesions that interfere with your ability to get pregnant.
These patches of endometrial tissue may also release estrogen, which could cause infertility by affecting egg development or stopping a fertilized egg from attaching to the uterine lining.
Reproductive surgery to treat infertility
Depending on what’s causing your fertility issues, you may benefit from one of the following surgical procedures:
Abdominal surgery (laparotomy)
A laparotomy is conventional open surgery. We make a long incision in your lower abdomen (and uterus when needed). Then we cut away the problematic tissue, such as fibroids or out-of-place endometrial tissue.
Laparoscopic surgery is preferred over laparotomy, because it’s a minimally invasive technique. We make a small incision in your lower abdomen and insert a laparoscope through the incision. The scope provides lighting and sends a magnified image to a monitor.
After inserting instruments through the scope or another incision, we remove the problematic tissue, such as scarring, adhesions, ovarian cysts, fibroids, or out-of-place endometrial tissue. We may also correct a malformed uterus.
Minimally invasive surgery usually causes less trauma to the body. As a result, you may heal faster, have less pain, and also have a lower risk for complications.
A hysteroscope is a special instrument designed to go through your vagina and cervix and into your uterus. We may recommend hysteroscopy to eliminate uterine polyps and fibroids.
Myomectomy refers to any procedure used to remove fibroids while preserving the uterus. We may perform an abdominal, laparoscopic, or hysteroscopic myomectomy, depending on the size, number, and location of your uterine fibroids.
Laparoscopic ovarian drilling
This minimally invasive surgery specifically targets PCOS. During the procedure, we make a small incision in your abdomen and guide a laparoscope through the opening to your ovary.
Once the scope is in place, we use a laser to destroy androgen-producing tissues in the ovary. The procedure lowers levels of androgens, which can increase your chances of ovulating.
If you have questions about gynecological conditions associated with infertility, we can help. To learn more, book an appointment online or over the phone with Fangyin Meng, MD, PhD, today.