Transvaginal Egg Collection (TVOR)

 

TVOR is the method used for the egg collection, once adequate number of follicles have been created at the end of the controlled ovarian stimulation. Collection through the abdominal wall is seldom and is only planned if the ovaries are difficult to reach via the vaginal access.

 

 

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Transvaginal Hydrosalpinx Aspiration

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Hydrosalpinx is the term used, when the fallopian tube is blocked and contains fluid. When there is a history of endometriosis, blood might be contained and on such occasions it is called haematosalpinx. Both hydro- and haematosalpinx can have a detrimental effect on the outcome of a fertility treatment. When there are contraindications to attempt surgical removal of the affected tubes i.e. medical background, or if it is an incidental finding on the day of egg collection, a transvaginal drainage is possible with antibiotic cover.

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Transvaginal Cyst Aspiration

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Ovarian cysts are very common in women. When these are simple and produce hormones they could interfere with the simulation process. To avoid this a transvaginal cyst aspiration can be performed before the beginning of the stimulation. The procedure is performed under sedation and the patient can be discharged once she feels fit and well The stimulation can start the day after the cyst aspiration.

 

 

 

 

 

 

Minimal Access Procedures

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Hysteroscopy

 

Hysteroscopy is the direct visualization of the uterine cavity. It is achieved with the introduction of a thin camera through the neck of the womb inside the cavity to assess the anatomy (diagnostic). If there are anomalies identified like polyps, fibroids (benign tumors of the muscle), adhesions (scar tissue) and anatomical deformities (septum) then these can be treated according to the indication (operative).

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Laparoscopy

 

Commonly known as “key hole surgery” laparoscopy allows us to asses the abdominal cavity and the pelvic anatomy (diagnostic) by introducing a camera through the belly button. If there is indication for treatment like hydrosalpinges, adhesions, cysts, fibroids, endometriosis etc. additional instruments are inserted in the tummy under direct vision and the appropriate procedure takes place.

 

Open Myomectomy

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This is a procedure indicated for the removal of fibroids when these are big in size or number. Access is allowed through an abdominal incision just above the Bikini line like the one in Caesarian Section. It enables a better assessment of the anatomy of the uterus and a more direct approach to the areas from where the fibroids need to be removed. The operation is performed under general anesthetic and intercourse or IVF treatment can be begin 6-12 months after the operation.