Being a mother is something many women dream of but some women find it extremely difficult to live this dream. An inability to conceive a child in 12 months or more of well-timed unprotected intercourse. The risk of infertility increases with age. Infertility can affect both men and women and can be triggered by a number of factors.
The risks of infertility increase with age. Obesity or being extremely underweight, smoking and alcohol consumption can also increase the risk of infertility. In addition, a diet that is deficient in zinc, folic acid and vitamin B12 can aggravate problems with conception. Ovulation and sperm production may also be affected by stress and exposure to chemicals, pesticides, etc.
Thankfully, in most cases, infertility is not a condition one has to live with. Treatment for infertility depends on the factors triggering infertility. Hence, the first step to deal with infertility is to understand the factors that cause this condition. Two of the most common causes of infertility include:
- Anovulation : Anovulation refers to the absence of ovulation. This condition is often caused by the polycystic ovarian syndrome. If an egg is not released by the ovaries, it cannot be fertilized by sperm and hence causes difficulties with conception.
- Tubal infertility: A blocked fallopian tube or scarring on the fallopian tube can by caused by pelvic inflammatory disease, STDS or endometriosis.
Fertility treatment includes:
- Ovulation induction: This involves stimulating ovaries in women suffering from anovulation and infertility with the help of medication. This can also be used to treat infertility caused by the polycystic ovarian syndrome. Ovulation can be induced with oral and injectable medication. The success of this form of treatment depends on the age of the woman, cause and the type of medication used.
- Artificial insemination: Intrauterine insemination can be used to treat unexplained infertility, early stages of Endometriosis, hostile cervical condition, including cervical mucus problems and ejaculation dysfunction in males. The age of the woman plays a significant role in determining the success of this form of treatment. Intrauterine insemination may be accompanied by the use of oral or injectable medication to stimulate ovaries.
- In Vitro Fertilization (IVF) or Inracytoplasmic sperm injection (ICSI) : Main indication of IVF is damaged or bilateral blockage of Fallopian tubes. This process involves stimulating Ovaries for developing multiple eggs which are then retrieved and fertilized in a laboratory and then embryos are transferred back into the uterus. IVF can be used to treat almost all forms of infertility except those caused by severe anatomic problems with the uterus and has a high success rate.
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Can laparoscopy help in dealing with endometriosis
Laparoscopy is one of the most common procedures for diagnosing and treating endometriosis. Instead of giving a big incision, this procedure of surgery uses a lightweight instrument through few small holes or incisions. There could be one or more incisions based on the number of instruments that require access inside the body. This procedure involves the use of a camera to ascertain endometriosis as well as treat it in the same sitting. This brings drastic improvement in infertility as well as in pain associated with the endometriosis. If a cyst is found in the ovary, the laparoscopic surgeon removes it very delicately without causing any harm to the normal ovary, as a part of the Laparoscopic Surgery for Endometriosis.
How does the procedure go?
Eating and drinking should be suspended before 8 hours of the laparoscopic surgery. The doctor takes a call on whether to give general or local anesthesia. Mostly, General anesthesia is given during such procedures. A person specialized in Gynecological Endoscopy ( Gynaec Laparoscopic Surgeon) is the best to perform such a procedure.
How is the procedure performed?
The abdomen is first inflated with gas with the help of a needle. It pushes the abdominal wall from the organs to give clear visibility to a surgeon. The laparoscopic Camera with a scope is then pushed through an incision to examine the internal organs. If endometriotic lesions are found then a doctor can use one of the several laparoscopic techniques such as electrocautery, excision, etc to destroy the same. Post surgery, the incision is closed with stitches. The whole procedure usually takes 30-60 minutes depending upon the severity of endometriosis.
Why is laparoscopy done?
- To diagnose endometriosis.
- Infertility associated with Endometriosis.
- If there is a endometriotic cyst more than 4 cm.
- If the endometriosis interferes with other organs such as the bladder, rectum etc.
- If the pain during menses ( dysmenorrhoea) does not subside with medication.
Duration of hospital stay:
Operations such as these are done as daycare procedures as these are less invasive. Patient need not spent more than a day in the hospital. Rarely in severe cases of endometriosis overnight hospitalization may also be required. One can successfully return to normal work within 1 week of the surgery.
Post-surgical treatment
Once the laparoscopic diagnosis is made and lesions treated, treatment depend upon the symptoms and age of patient. If patient is desirous of pregnancy then accordingly ovulation induction and either IUI or IVF is done. If patient does not desire for pregnancy then she can be put on hormonal therapy.