Role of Endoscopy in Infertility

 

Endoscopy is a minimally invasive procedure used for infertility diagnosis and treatment.

It is by definition done by accessing the site of intervention, either a cavity or an organ.

It refers to the procedure in which a flexible tube with lights and a camera is used to examine and treat infertility problems.

This includes diagnostic (to examine pelvic region) and operative (to treat defects by surgical procedure).

The two endoscopy procedures often carried out are Hysteroscopy and Laparoscopy.

 

 

Hysteroscopy and Laparoscopy

·         Hysteroscopy is a procedure in which the uterine cavity is inspected by passing the endoscope through the cervix.

 

Conditions that can be treated using Hysteroscopy are: fibroids, polyps, septum, etc.

When is Hysteroscopy recommended?

If you experience the following issues, then the doctor may recommend Hysteroscopy.

o   Intrauterine adhesions

o   Submucous fibroid

o   Intrauterine polyp

o   Assumed uterine abnormalities (Example, Bicornuate uterus, Septate uterus, etc.)

o   Recurrent IVF/implantation failures

 

·         Laparoscopy is meant to visualise the uterus, ovaries, tubes, and pelvis by placing an endoscope in the abdominal cavity, generally through the umbilicus.

 

It involves small incisions and is advantageous to treat a woman’s infertility.

 

The patency of the tubes can also be examined by injecting a blue dye. Abnormalities such as adhesions, fibroids, Endometriosis, etc. can be treated using Laparoscopy.

 

When is Laparoscopy Recommended?

Laparoscopy is recommended if you experience any or all of the following:

o   Symptoms that indicate pelvic infections, any previous pelvic surgery or previous ectopic pregnancy, Endometriosis (Dysmenorrhea, Dyspareunia, Chronic pelvic pain)

o   Unsolved Infertility

o   Recurrent IUI failures (usually 2 to 3)

o   Doubt of genital tuberculosis

Advantages

Endoscopy is performed to find the specific reason behind the abnormality. The main advantage being that it is minimally invasive and we can avoid large cuts on the body.

Endoscopy surgery is a less aggressive technique, with less bleeding and complications. The Postoperative time is smaller and recovery is better for the patient. Hence, the hospital stay will be shorter and the return to regular lifestyle will be earlier.

It also ensures much better treatment of reproductive problems, since the visualization of internal genitals like ovaries, uterus, fallopian tubes, etc. is clear and direct.

It also helps in preventing internal adhesions and provides better outcomes in successive assisted reproduction treatments.

With Laparoscopy, one can directly visualise the deformities in ovaries, fallopian tubes, the outer surface of the uterus, and the pelvis that may harm a woman’s fertility.

Whereas, Hysteroscopy enables direct visualisation of defects inside of the uterus that might hamper implantation.

Laparoscopy and Hysteroscopy both are crucial to enhance the success of IVF treatment. Hysteroscopy is helpful for every individual undergoing IVF treatment, whereas laparoscopy is performed selectively as indicated.

With improved technology and better instrumentation, the efficiency of these procedures has tremendously increased.

Moreover, progress in imaging systems and more secure energy sources for operative procedures have augmented the role of laparoscopy and hysteroscopy in increasing the success of IVF treatment.

Risk of Endoscopy

Endoscopic surgeries are generally safe procedure and completion are uncommon less than 2 out of 100 patients may experience minor complications such as bleeding, infection, etc. Major complications such as accidental perforation of uterus, injury to surrounding organs are rare and minimal in experienced hands. Other medical complications due to anaesthetic drugs used or fluid overload in operative hysteroscopy may be encountered uncommonly.

Final Words

In any case, the overall assessment of an individual or couple tryingfor a successful pregnancy is important to effectively determine the need of endoscopy.

Disclaimer

Though all attempts are made to provide correct information on the subject, inadvertent & typographical errors arising out of manual intervention cannot be ruled out. It is requested to bring any such discrepancies to the notice of the blogger for correction.