The doctor can consider a surgical procedure for women with a fertility problem who require a thorough examination of the internal reproductive organs (diagnostic procedure) and for women with a fertility problem as a result of an anatomical abnormality which can be repaired surgically (curative procedure). The diagnostic procedures, using hysteroscopy, endometrium biopsy or laparoscopy, have already been covered in the section on tests for women. Below, we discuss briefly the most important curative procedures.
The tube - inserted through the vagina and cervix into the uterine cavity - is slightly thicker than that used for a purely diagnostic hysteroscopy because, as well as containing a duct for seeing through, it also contains a duct along which a cutting electric loop can be inserted. This enables polyps, fibroid tumours (myomas), adhesions or septum tissue in the uterine cavity to be removed. The procedure is carried out in the surgical day centre under general anaesthetic.
Operative procedures in the abdominal cavity
Via laparoscopy (keyhole surgery) or via laparotomy (open abdominal surgery) to remove adhesions in the abdominal cavity with or without sealing the fallopian tubes, to remove fibroid tumours outside the uterine cavity, fallopian cysts, to repair the fallopian tubes after sterilization, to treat endometriosis. Depending on the estimated operating time, this can be carried out in one day (cf. Tests chapter) or during a longer period of hospitalization. In principle, as many procedures as possible are carried out using laparoscopy because of the quicker recovery time and smaller scars. In rare cases, however, this technique is not possible. In these cases, a laparoscopy turns into an open abdominal procedure because the procedure is more difficult than expected or because a complication arises, making open abdominal surgery necessary.