While the most successful treatments for infertility are the assisted reproductive technologies (ART), certain patients have anatomical causes of infertility and require surgery to correct anatomical disorders of the uterus, fallopian tubes and ovaries, to help restore reproductive function.
Most reproductive surgery is minimally invasive—resulting in no or small incisions—and can be performed through an endoscope on an outpatient basis. An endoscope involves the use of either a laparoscope (a small telescope inserted into the abdominal wall) or a hysteroscope (a small telescope inserted within the uterine cavity). Minimally invasive surgery is often associated with less pain than traditional surgery and allows patients to return home the same day.
Dr. Mansfield is experienced and trained to perform the following pelvic or reproductive surgeries:
This procedure corrects the blockage or scarring of the fallopian tube(s), which can hinder the sperm and egg from reaching one another in order for fertilization to occur. This is often referred to as tubal infertility. Blockage or scarring may occur as a result of a previous pelvic infection, inflammation including endometriosis and previous pelvic surgery.
This procedure is the reopening or reconnecting of “tied” fallopian tubes from a previous tubal ligation or “having your tubes tied.” A number of factors including the patient’s age and how the tubes were tied determines if one is a candidate for this procedure. Not every tubal reversal is successful, but as many as 75 percent of couples achieve pregnancy.
Uterine malformation is the result of abnormal development of the uterus, fallopian tubes, cervix and/or vagina during fetal development. These abnormalities can result in symptoms including no menstrual cycles (amenorrhea), infertility, recurrent pregnancy loss and chronic pelvic pain. Whether surgery is needed depends on the extent of the individual’s problem.
It is estimated that endometriosis occurs in roughly five to 10 percent of women. Endometriosis is a condition where tissue that normally lines the uterus develops outside the uterine cavity in abnormal locations such as the ovaries, fallopian tubes and abdominal cavity. Symptoms may depend on the location of the excess tissue development and can include pelvic pain (often worsening during the menstrual cycle), painful intercourse and infertility. Treatment, such as hormone therapy, surgery or both, may help relieve the pain associated with endometriosis and restore one’s fertility.
Some women who have had previous pelvic surgery, pelvic infections or suffer from endometriosis may have a buildup or excess of scar tissue. Surgical procedures can be performed to remove the scar tissue that can restrict the egg from reaching the fallopian tube. With endometriosis, the growth and bleeding cycle of endometrial implants causes irritation, inflammation and a release of toxins that produce scar tissue around the ovary. In this case, the entire ovary or fallopian tube can become encased in scar tissue and, in more severe cases, can stick to nearby structures such as the bowel.
Approximately 30 to 50 percent of women have fibroid tumors, which are typically benign, non-cancerous growths of muscle in the wall of the uterus. While most fibroid tumors go unnoticed, some can grow during the reproductive years. Depending on their size and location, they can cause infertility, recurrent miscarriages, excessive uterine bleeding, pain and pressure or severe anemia. Also, depending on their size and location, fibroid tumors can be removed either hysteroscopically or laparoscopically to restore normal fertility and menstrual function.
Although these fluid-filled sacs within the ovary are usually benign, non-cancerous and resolve on their own, some ovarian cysts cause infertility and pain and may require surgical removal.
Abnormal Uterine Bleeding
Heavy or irregular bleeding between periods happens for different reasons including polyps, fibroids or cancer. This bleeding can also occur without any apparent cause and is also referred to as Dysfunctional Uterine Bleeding (DUB). Treatments include hormone therapy or hysteroscopic surgery.