Infertility Surgery

In addition to the full spectrum of infertility services offered at California IVF, Davis Fertility Center, there are many surgical procedures offered to patients who may or may not be currently seeking infertility treatment. Dr. Zeringue has particular expertise with laparoscopy, endometriosis, uterine fibroids, and tubal re-anastomosis. Below you will find an introduction to the individual procedures offered. For a discussion of your individual options please schedule an appointment by calling 530-771-0177.

Many infertility surgeries not required for general health and well being but may be very beneficial in helping women acheive a successful pregnancy. The indications of the procedure and alternative treatments will be discussed before any surgery is planned. It is imperative you make an informed decision about surgery. You should never feel pressured into having surgery and you should not agree to surgey without understanding everything. If you decide to have a surgical procedure to help with your fertility care, there will be several steps involved.

After a thourough discussion of your options and the surgery to be performed you will need to sign an informed consent document. This document is simply a statement saying you understand the procedure, risks, and alternatives. Often, these documents list most of the complications that can occur from surgery. This is not to frighten you but is considered necessary information. You should feel comfortable asking about these complications. The consent document does not obligate you to surgery and you may change your mind at any time before the surgery.

Preop - Once your surgery has been scheduled and you and your physician have discussed the operation to be performed, you will be scheduled for a preoperative appointment. These appointments frequently involve preadmission paperwork and instructions. You may have blood tests drawn before or during this appointment. A pregnancy test and blood count are the most common tests. Most of the time these preoperative appointments will occur at the surgery center or hospital. Additional instructions about this appointment will be provided when your surgery is scheduled.

Be certain not to eat or drink anything on the night before your surgery. This is called "NPO". You will be given a time to start fasting. This is very important to reduce the risk of complications. If you do not follow these instructions you run the risk of having your surgery canceled for your own safety.

Post Op - Following your surgery your recovery time will vary depending on the procedure performed. Most laparoscopy cases are done as same day surgeries. Myomectomies and tubal reversals are most often done as extended outpatient procedures. This simply means the patient remains overnight but is not admitted as an inpatient (This allows for a significant cost savings). Following your procedure you will be given written discharge and post operative instructions. Activities and diet are limited by your level of comfort. Start slowly and gradually progress your level of activity as tolerated. Laparoscopy, hysteroscopy and D&C procedures have quicker recovery times than the more major procedures. You should be able to resume driving within 24 hours provided you are not taking medications that impair your abilities to drive. The major procedures involving a laparotomy (large incision in the abdomen) will require a longer time of recovery. After a major surgery you should avoid driving for up to 4 weeks. Follow up visits are usually scheduled at the time your surgery is scheduled. They will range from 1-4 weeks after your surgery depending on the procedure and availability of appointments.

Procedures

There are many different types of surgeries that are possible when one considers the multiple combinations of procedures possible. Among these are the following:

Hysteroscopy
Diagnostic & Operative Hysteroscopy involves the use of a thin scope to look into the cavity of the uterus. The scope can be used to guide operative instruments. [More Information]

Laparoscopy
Diagnostic & Operative Laparoscopy involves placing a scope into the abdominal cavity through a small incision at the navel. One and sometimes more smaller incisions may be made in the abdomen to introduce instruments used to explore the abdominal cavity and perform the necessary surgery. [More Information]

Myomectomy
A myomectomy is a procedure involving the removal of a fibroid or fibroids, also known as myomas or leiomyomas. [More Information]

Tubal reanastomosis
Tubal reanastomosis is a microsurgical procedure where the ends of a previously interrupted tube (tubal ligation) are put back together. This allows for attempts at pregnancy following a tubal ligation without having to undergo IVF. [More Information]

Neosalpingostomy
This is a procedure where blocked or dilated tubes are opened and the ends of the tubes are surgically recreated. This allows attempts at achieving pregnancy without IVF. [More Information]

Chromopertubation
This procedure is often done in combination with the other procedures. This involves injecting colored liquid through the fallopian tubes and watching the ends of the tubes for the dye. Spillage of dye indicated open (patent) tubes.

Hysterectomy
This is the removal of the uterus and cervix. There are many reasons for this procedure to be performed. Vaginal hysterectomies involve the removal of the uterus through the vagina while abdominal hysterectomies require a laparotomy (incision into the abdomen). Vaginal hysterectomy is usually associated with fewer complications and faster recovery. Oophorectomy This is the removal of the ovaries. Removal of the ovaries does not have anything to do with the terms complete or partial hysterectomy (complete and subtotal (partial) depend on the removal of the cervix).