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Many couples hope that an operation will finally solve their problem and result in a pregnancy. However, in most cases this is not the case. Nevertheless, these surgical interventions for fertility disorders have a high diagnostic value.

In women

A laparoscopy is a surgical procedure performed under general anaesthesia to examine the abdomen. The outside of the uterus, fallopian tubes and ovaries can be examined. During the laparoscopy, endometriosis cysts or foci, or adhesions of the fallopian tubes, ovarian cysts, uterine fibroids can be removed or treated. Above all, the patency of the fallopian tubes can be checked by injecting blue fluid into the uterine cavity and the surgeon checking whether it is flowing through the fallopian tubes into the abdominal cavity.

The laparoscope (a thin instrument containing a camera) is inserted through a small incision just below the navel. In order to see the organs better, the abdomen is ‘inflated’ with a little carbon dioxide gas. The doctor can then get an overview and assess the organs that are now visible. In many cases, recordings are made during the examination. Should any treatment be necessary, one or two further incisions are made in order to insert surgical instruments. As with any surgery there is a risk of complications, such as bleeding, infection, injury or problems with the anaesthesia.

A hysteroscopy is not only an important diagnostic method, it can also be used to treat certain cases of infertility. It enables the doctor to examine the inside of a woman’s uterus. For example myomas, changes in the mucous membrane, adhesions inside the uterus, malformations and tumours can be detected and, if necessary, treated immediately.

Here, a tubular instrument equipped with a light source – the hysteroscope – is inserted through the vagina and cervix into the uterus. Once the hysteroscope is inside the uterus, gas or liquid is introduced through the instrument to separate the walls of the uterus; this makes it easier for the doctor to examine the uterine cavity. Surgical hysteroscopy uses a larger hysteroscope (as opposed to a diagnostic hysteroscopy) so that surgical instruments can be placed in the uterine cavity via the hysteroscope. A diagnostic hysteroscopy can be done on an outpatient basis. However, a short general anaesthetic is required for the surgical procedure. As with any surgical procedure there is a risk of complications, such as injury to the uterus or infection.

In men

Varicoceles surgery: Large varicoceles (varicose veins in the scrotum) could potentially reduce a man’s fertility. Surgical treatment usually involves making a small incision into the groin area under general anaesthetic and tying off the affected testicular vein. Complications can include bruising and inflammation of the epididymis. A recurring varicocele can also occur.

There is also a possibility of destroying or sticking together the affected testicular vein. A certain active ingredient is introduced into the enlarged testicular vein through a small incision in the scrotum with the help of a thin tube.