Many women with fertility problems could have a significantly better chance of having a baby if modern IVF techniques are combined with more traditional surgical interventions, according to a leading fertility specialist.
Mr TC Li, Honorary Professor at Sheffield Hallam University, says that surgical techniques should be used alongside IVF more often, especially for women who have repeatedly failed to conceive using IVF alone.
He explained in a lecture at Sheffield Hallam University that when IVF was first pioneered it was considered to be more effective than surgery and less invasive. However, as time has gone on surgical interventions have improved, but fertility treatment has yet to catch up with these developments.
Mr Li explains, “Surgery has improved significantly over recent years and in some cases can increase the chances of successful conception through IVF.
“For example, if a woman has blocked fallopian tubes fluid from the tubes can seep into the uterus, preventing the embryo from implanting. By surgically dealing with the blocked tubes the IVF has a much higher chance of success. Endometriosis is another common condition that can be helped with surgery.
“Basically, sometimes the woman’s body is not able to support an embryo, which is why IVF fails. Surgery can correct some of these problems and give her the best possible chance of conception. This type of surgery can also help some women who have suffered from repeated miscarriage.
“I had one patient, Zoe, who suffered from fibroids and a hormonal problem and had been trying unsuccessfully for a baby for years. She had suffered five miscarriages and was on the verge of paying ?10,000 for pioneering treatment abroad. I looked into her case and by combining the two techniques she was able to conceive through IVF and now has a healthy one year old son.”
Zoe says, “I had five miscarriages and was told by doctors that I would never have a baby and should look into a hysterectomy when I was only in my twenties. I had already had two surgeons try unsuccessfully to remove fibroids and was admitted to hospital several times a year due to heavy bleeding.
“I heard about Mr Li when I did a presentation on hypnotherapy and complementary medicine at his hospital and he was the first doctor who thought I had a chance of conceiving. I never gave up hope and neither did he. It took more surgery and months of daily tests but I eventually fell pregnant with my son and this time I didn’t miscarry.
“I know that women with severe fibroids and other gynaecological problems can give up when they are told by a doctor that there is no chance of conceiving, but I hope that my story with encourage them to ask for a second opinion and not to give up hope.”
Mr Li says, “It is crucial that we ensure our trainee gynaecologists have the skills necessary to both recognise problems that could benefit from surgical intervention and to remedy them. Some young doctors now don’t see enough surgery during their training to be confident in these techniques.
“Both IVF and gynaecological surgery have been around for a long time. By combining the strengths of these two techniques doctors can help more of the one on seven couples with fertility problems to conceive.”
Revision date: July 5, 2011
Last revised: by Janet A. Staessen, MD, PhD