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OVARIAN STIMULATION AND INTRAUTERINE INSEMINATION (IUI) INTRACYTOPLASMIC SPERM INJECTION (ICSI) -- REPRODUCTIVE SURGERY Our physicians have expertise in surgical correction of anatomical problems which may cause infertility. Diagnostic laparoscopy is an outpatient surgical procedure, which allows us to directly visualize the pelvic organs, inspect for signs of endometriosis or adhesions, and to assess the relationship between the fallopian tubes and ovaries. At the time of surgery, corrective procedures can be performed to restore normal anatomy. Adhesions can be removed, endometriosis can be coagulated or vaporized with a laser, and ovarian cysts can be removed. If an anatomical factor is the only cause identified for infertility, the corrective surgery may allow conception to occur naturally and without additional treatment. If disease has caused extensive changes in pelvic anatomy, or if the pathology is too large to be removed by laparoscopy, then a laparotomy may be required. This procedure involves a larger incision in the abdominal wall (similar to a cesarean section) and a longer post-operative recovery period. The larger incision allows direct access to the pelvic tissues and allows the surgeon to perform more extensive reconstructive procedures. For example, uterine fibroids are benign tumors that originate in the muscle layer of the uterus, and often require a laparotomy incision to remove them and reconstruct the uterus. Hysteroscopy is an outpatient surgery performed inside the uterus. A hysteroscope is a narrow teloscope-like instrument, which is inserted through the cervix to allow visualization of the interior of the uterus. Polyps, adhesions and submucosal fibroids can be excised by this procedure. The goal of surgery on the reproductive organs is to correct and restore normal anatomy to allow normal physiologic relationships between organs. Since any surgical interruption of tissue integrity can induce adhesion formation, great care must be placed on the handling and treatment of these delicate tissues. Our extensive training and experience as reproductive surgeons has instilled in us a deep respect for the proper care and treatment of the pelvic organs.
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