Reproductive surgery is surgery in the field of reproductive medicine. It can be used for contraception, e.g. in vasectomy, wherein the vasa deferentia of a male are severed, but is also used plentifully in assisted reproductive technology. Reproductive surgery is generally divided into three categories: surgery for infertility, in vitro fertilization, and fertility preservation.
A reproductive surgeon is an obstetrician-gynecologist or urologist who specializes in reproductive surgery.
Reproductive surgeries will be referred to based on biological sex, and terms such male and female will be used to denote to men and women respectively.
Uses
Reproductive surgery aims to address concerns spanning from male and female fertility to gender-affirming care. Uses for reproductive surgery may encompass different abnormalities, dysfunctions, and areas of focus that are unable to be treated solely through medication or nonsurgical treatment. Screening measures may be completed to determine the necessity of surgery. For example, intrauterine pathology may be assessed by utilizing techniques such as hysteroscopy to identify complications for reproductive surgical interventions.
Assisted reproductive technology (ART) supports enhancement of fertility success through processes such as in vitro fertilization (IVF). Screening and reproductive surgery also have a role in identifying and addressing abnormalities, such as notable cysts, prior to initiating IVF. Surgical sperm retrieval is an alternative means of semen collection, where other means are not possible in circumstances like posthumous sperm retrieval or male infertility.
These surgical techniques may also be utilized as a form of permanent contraception referred to as sterilization. A vasectomy or tubal ligation would be examples of this procedure for male and female individuals respectively. Reproductive surgeons can potentially perform a reverse vasectomy to restore male reproductive function following the vasectomy. Individuals may choose to reverse the procedure due to pain experience after the surgery.
People might find themselves wanting to preserve their fertility. Biological material such as sperm or oocyte are capable of being surgically collected and preserved cryogenically. Fertility preservation also provides individuals who are receiving gender-affirming surgeries the option of preserving gametes if having biological children is desired following the procedures and hormonal therapy.
Reproductive surgery is also considered for complications such as endometriosis, polycystic ovary syndrome, ectopic pregnancy, and vas deferens obstruction.
Trends
History
Albeit an increase in overall use of assisted reproductive technology (ART), surgeries on the fallopian tubes and ovaries have decreased, leading to a rise in insecurity in the field of reproductive surgery. Reproductive surgery in women has largely been complementary to other ART methods such as medication, except for in tubal infertility, where surgery remains the main treatment. Although reproductive surgery has been most relevant for severe symptoms, there has been a strong interest in greater analysis surrounding this topic of research.
Reproductive surgery first began with fertility sparing surgeries, such as uterine myomectomy, and was transitioned later into the addition of surgeries for infertility and the advancement of success rates for fertility. Hysterectomies and myomectomies date back to ancient times, where fascination grew around fertility sparing surgeries, specifically for young women who were able to conceive but were considered to have suspected ailments. However, the lack of knowledge of medicine eventually led to mortality, thereby causing myomectomies to become more uncommon. Overtime, various advancements and extensive research allowed for the discovery of minimally invasive myomectomies, which became popular among women who were capable of bearing children.
Laparoscopy continues to be a common procedure approach as it is minimally invasive and is thought to be associated with a decrease in hospital stay and surgical complications. The development of newer technology and surgical techniques allowed for the increase in success rates for various other surgeries, such as endometriosis and adenomyosis surgeries or adnexal surgeries.
