Reproductive surgery are procedures done to open up fallopian tubes which were blocked or to restore the anatomy of the pelvic organs which were damaged or distorted by adhesions (scars) caused by past infections, endometriosis or previous surgery. In specially selected cases where the damage is not severe and where surgery may enhance the woman’s chances of achieving spontaneous pregnancies, then she will be offered corrective surgery. Operations on distally blocked tubes (hydrosalpinges), endometriosis, pelvic adhesions are often done through operative laparoscopy while in my practice, proximal tubal blockages and reversal of tubal ligations (sterilisation) where the tubal lumen is tiny and the width of a human hair, the tubal repair surgeries are done by open microsurgery. The advantage of tubal surgery is that if successful, she can conceive naturally and repeatedly, while the negative aspects of tubal surgery would be failure to conceive, ectopic pregnancies and of course the potential complications of major surgery. For women with severely damaged tubes or badly damaged pelvis by severe adhesions or for the older woman time for childbearing is a limiting factor, the preferred treatment for tubal factor infertility is IVF or ICSI.
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