In a perfect world, you would have no trouble getting pregnant when you decide you want to have a baby. But that’s not the reality for many women. After a year of trying but not conceiving, or six months for women 35 and older, doctors start using the word infertility.
After initial testing to rule out certain conditions that may prevent pregnancy, your gynecologist or a reproductive endocrinologist might prescribe letrozole or clomiphene citrate, go-to medications that help females ovulate.
When those don’t do the trick, a more aggressive option known as in vitro fertilization (IVF) is the next – and usually final -- step in most situations.
In some instances, though, an operation might be a better choice.
Surgery might seem drastic, especially when we feel fine. But the small procedures may be your best bet for ultimately having a baby in your arms.
Put an End to Endometriosis
More than a third of women who struggle to get pregnant have endometriosis, according to The American College of Obstetrics and Gynecologists. Essentially, endometriosis is uterine tissue gone rogue. Babies grow in the uterus, which is lined with a certain type of tissue. That tissue sometimes shows up elsewhere:
- outside of the uterus
- inside the ovaries
- on the fallopian tubes — which are the highway via which the sperm travels to the egg
Along the way, that troublesome tissue makes scar tissue, which in turn leads to inflammation and, sometimes, pain.
In other words, when misplaced endometriosis tissue or the scar tissue it causes blocks the sperm’s path to the egg, you can’t conceive a child.
Your doctor can peek inside to see if you have endometriosis and remove it if you do — opening the pathway to conception. Doctors do this using a procedure known as laparoscopic surgery, which involves making three or four small incisions. One cut is in your belly button. That allows the doctor to insert a tiny camera that allows a view of the whole pelvic cavity, which is the area where you may need work. The other incisions allow your doctor to place and maneuver the instruments needed to perform the surgery.
When doctors see endometrial implants and/or scar tissue in places they don’t belong, such as the fallopian tubes, they can remove them. This might entail a “lysis of adhesions” that reduces the scar tissue.
In some cases, the endometriosis causes various parts of your anatomy to stick together; during surgery doctors can separate what shouldn’t be attached.
In certain circumstances, the doctor will insert a dye into the uterus. If the dye fills the pelvic cavity, it proves the fallopian tubes are open. If not, it guides the doctor on how to proceed. If it’s necessary, your doctor might make a larger incision. In those cases, the surgery is called laparotomy.
How To Fix Fibroids
Fibroids are noncancerous growths. When they’re in your uterus, they might prevent you from getting pregnant. You’ll likely be sent for an ultrasound and, if needed, an MRI to determine if you have fibroids, where they are and how large they are. Then, if you have trouble conceiving a baby or have severe pain, your doctor might suggest a myomectomy, which is a procedure to remove fibroids.
Some doctors do the myomectomy using an open procedure, but a laparoscopic version is minimally invasive. Your doctor may opt for a robotic-assisted approach in which small incisions result in little bleeding and a better recovery. After a robotic myomectomy, you’ll feel fine within a few days, although you’ll be told to wait four to six months before trying to get pregnant again.
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