Reproductive surgery is any surgery performed on the reproductive system in both men and women. It is most commonly used for either contraceptive reasons, such as vasectomy and tubal ligation procedures, or in assisted reproductive technology, such as intrauterine insemination (IUI) or in vitro fertilization (IVF). Reproductive surgery is also sometimes necessary for treating health conditions such as endometriosis and obstructed fallopian tubes in women, and obstructed vas deferens in men.
Contraceptive reproductive surgery has high rates of pregnancy prevention, generally hovering around 99% for vasectomy and tubal ligation procedures. Vasectomy surgeries are usually performed by a urologist, a doctor specializing in treatment of the urinary tract in both men and women. This surgery takes about half an hour and is performed under local anesthesia, which means that the patient will be awake but numbed for the duration of the surgery. Tubal ligation procedures also take about half an hour, and they are performed by a gynecologist under general anesthesia, which means that the patient will be asleep during the surgery. Urologists and gynecologists also specialize in vasectomy and tubal ligation reversal procedures, which are forms of reproductive medicine that serve as pregnancy aids, rather than methods of pregnancy prevention.
Assisted reproductive technology is an area of reproductive surgery that is constantly growing, and it encompasses the fields of IUI and IVF, which are both aimed at helping couples become pregnant through surgical means. IUI, sometimes referred to as artificial insemination (AI), is a procedure in which sperm are introduced into a woman’s uterus during a time when she is fertile. This procedure can aid couples who have not been able to conceive naturally, or women who elect to become pregnant through the use of donor sperm. The success rate of IUI is generally around 15% to 20% for each cycle, with up to 60% or 70% of women becoming pregnant after six cycles of IUI.
IVF is the process of creating a fertilized egg cell in vitro, or outside of the body, and then implanting it surgically into the woman’s uterus. It is more costly than IUI and other AI methods, which means that many couples will wait before electing to undergo an IVF procedure. Pregnancy rates with IVF range from about 35% to about 65%, according to various studies.
Reproductive surgery is also used to treat health conditions in both men and women. Gynecologists will sometimes perform surgery on women who have obstructed fallopian tubes or endometriosis, a condition in which the uterine lining begins to grow outside of the uterus. During these procedures, the gynecologist will remove the excess tissue. Similarly, a urologist will remove the blockage during a vas deferens obstruction surgery.