Role Of Laparoscopy And Hysteroscopy In Fertility Enhancement!

It has been more than 3 decades since IVF procedures are being practiced, and they have refined a lot over time, but still, more traditional procedures like Laparoscopy and Hysteroscopy are often required. These are primarily used to diagnose the causes of infertility and can also sometimes be used in operative role to cure some of the causes and help treat infertility. In fact, in many of the cases, diagnostic and operative role is played in conjunction; so, if a doctor detects an abnormality during the diagnostic procedure using Laparoscopy or Hysteroscopy, he/she can also choose to treat the condition immediately, if the situation warrants. The purpose of Laparoscopy or Hysteroscopy is to perform internal examination of pelvic organs, so as to examine the conditions causing infertility. This is something that cannot be performed from outside, and needs a more thorough look at the organs inside. Even though Laparoscopy or Hysteroscopy sound similar, there is a marked difference between both. Let’s find out what separates them.

What is Laparoscopy?
A Laparoscopy is a procedure used to detect gynecological problems. This involves inserting a telescope through the navel to see the internal parts. The images from the telescope are visible on a monitor. The patient is placed under general anesthesia during this time, but this is an outpatient procedure and the patient can leave for home the same day. Some of the problems that can be detected by Laparoscopy are cysts, scar tissue, endometriosis, fibroids and ectopic pregnancy.

What is Hysteroscopy?
A Hysteroscopy is also carried out by a telescope-like device, mounted with a camera at the front, and projecting the images on a monitor. The device used to perform Hysteroscopy is called a hysteroscope. The hysteroscope is passed through vagina and cervix into the womb. This does not require any cuts. In some cases, it does not even require anaesthesia, though some doctors might choose to give local anaesthesia. A Hysteroscopy is primarily carried out in conditions like heavy bleeding during periods, difficulties in getting pregnant, miscarriages, etc. It is also used to diagnose fibroids and non-cancerous growths (polyps in the womb).

Apart from diagnosis and investigation, Hysteroscopy is also useful for surgery of fibroids to remove fibroids and treat that as a condition of infertility, and removal of polyps.

Specific Use Cases of Laparoscopy and Hysteroscopy in Infertility Treatment-
Here are some specific conditions in which the doctor can choose to go with Laparoscopy or Hysteroscopy for treating the underlying condition that might be causing infertility:

Hydrosalpinx-

• In this condition, Fallopian tube is filled with clear fluid (called serous) and the tube is blocked.
• The diameter of this blocked tube can increase to many centimeters, and lead to infertility.
• This situation can be diagnosed using Laparoscopy. While performing Laparoscopy, it can be identified that the condition is present, and also identification of the impacted area as well as adhesions that might be affecting other organs.
• During Laparoscopy, the surgeon can also choose to intervene and manage this situation by performing surgery.

Bicornuate Uterus-

• A Bicornuate Uterus is a condition in which the uterus becomes heart-shaped. Even though uterus has only one cavity, a Bicornuate Uterus has two conjoined cavities. This condition can lead to complications during pregnancy.
• A doctor can diagnose this condition using Hysteroscopy. The doctor can choose to further confirm the diagnosis using Laparoscopy.
• A Bicornuate Uterus does not have to be corrected but should be regularly watched for preterm dilation. In case a surgical procedure is required, a cervical reconstruction surgery can be carried out via Laparoscopy.
• In case the condition is a septate uterus (single cavity, round on the top), then hysteroscopic surgery can be used to treat this.

Conclusion-
Laparoscopy and Hysteroscopy can sometimes present easier outpatient procedures for identification, treatment, and management of some of the conditions that might be causing infertility. In other more serious conditions, IVF could be recommended by the gynaecologist.