Your Guide to Fertility Surgery: Hysteroscopy, Laparoscopy & More

When you're having trouble conceiving, you may need to undergo fertility surgery (such as hysteroscopy, laparoscopy, or myomectomy) in order to increase chances of conception and remove impediments to implantation. In this guide, we explore how these procedures can help and what to expect from a visit to Illume Fertility's surgical suite.  

In this article:

• Fertility Surgery 101
• What procedures does Illume Fertility offer?
• Our Surgical Team
• What to Expect the Day of Your Surgery
• What to Expect: Post-Op Care
• Fertility Surgery FAQs
• What We Want Patients to Know

Fertility Surgery 101

As Manager of Surgical Services here at Illume Fertility, my job is to ensure that everything runs smoothly each day in our surgical suite. I work closely with our Surgical Director, Dr. Spencer Richlin, and an exceptional team of anesthesiologists, nurses, medical assistants and other staff to provide each patient the best care possible.

We are proud to have a fully-equipped surgical suite at our Norwalk, CT location, allowing us to care for patients on-site without the hassle of visiting an outside hospital or surgery center.

We have multiple embryo transfer rooms, a surgical procedure room and a quiet recovery area where patients can receive calming laser acupuncture treatment before and after embryo transfers and recuperate after their procedures. 

Our surgical suite has been accredited by the Accreditation Association for Ambulatory Health Care (AAHC) since 2003. We are inspected by the AAHC every three years, and this voluntary inspection we choose to undergo demonstrates our dedication to maintaining an exceptionally high standard of surgical care.

What procedures does Illume Fertility offer?

As a fertility clinic, we routinely perform the following minimally-invasive diagnostic and therapeutic procedures at our Norwalk location. With each procedure, our eight experienced surgeons are able to help patients get closer to their fertility or family-building goals. 

Hysteroscopy

Laparoscopy 

Laparoscopy is a minimally invasive procedure that uses a telescopic camera to evaluate the uterus, fallopian tubes and ovaries. It can also reduce the need for more complex procedures.

Myomectomy

Myomectomy refers to the surgical removal of uterine fibroids. In contrast to a hysterectomy, the uterus remains preserved with this procedure, ensuring the patient retains their reproductive potential.

Dilation and Curettage (D&C)

Dilation and curettage (D&C) is a procedure that involves clearing any remaining products of conception from inside the uterus after a miscarriage. Genetic testing can then be performed on any collected tissue to hopefully improve chances of future fertility treatment success. 

Grieving a pregnancy loss? You're not alone. We encourage you to explore our resources and receive 1-on-1 support from our Patient Advocate, Lisa Rosenthal.

Egg Retrieval

Transvaginal oocyte retrieval (or egg retrieval) is a technique used with in vitro fertilization (IVF) treatment to collect eggs from each ovary using vaginal ultrasound and gentle suction, enabling us to freeze the eggs for future use, fertilize the eggs and then freeze the embryos for future transfer, or have a fresh embryo transfer around five days post-retrieval.

Embryo Transfer

Embryo transfer refers to the final step in the process of in vitro fertilization (IVF) in which an embryo is placed into the uterus with the intent to establish a pregnancy. Embryo transfers do not require anesthesia or incisions and are performed in our designated transfer rooms. 

Our Surgical Team

We rotate through eight surgeons (our team of specially-trained reproductive endocrinologists), with each physician performing procedures on their assigned day.

Although the surgeon performing your procedure may not be your primary physician at Illume, rest assured that they have carefully reviewed the treatment plan you and your primary physician created together. You will always be asked to sign paperwork confirming all details before a procedure to ensure everyone is on the same page.

Prior to bringing you into the procedure room, your surgeon will introduce themselves to you and give you a chance to get to know them or ask any questions you may have. 

We work with a small group of expert anesthesiologists, as we value close working relationships and continuity of care. The anesthesia team works harmoniously with our practice and patients to ensure you are comfortable throughout your procedure.

How do you find the best fertility clinic?

Get our free guide to choosing the right fertility clinic, affording treatment, and finding success rate data.

What to Expect the Day of Your Surgery

Feeling a little anxious about your upcoming procedure? It's normal! Let's demystify the process by walking through what to expect on the day of your surgery.

Before Your Procedure

On the day of your procedure, you will arrive one hour prior to your scheduled surgery time at our Norwalk, CT location. As soon as you arrive, you will check in with our front desk team.

Shortly after, one of our team members will escort you from the waiting room back to our surgical suite to be prepped by one of our OR nurses. You will then have the chance to meet and speak with your assigned surgeon and anesthesiologist. 

Our primary goal is to create a supportive and comfortable experience for you. You will be handed a warm gown and blanket from our heated linen closet. After getting tucked into one of our recovery suites, you will be greeted by me or one of our other recovery nurses.

Before we dive into your paperwork, we will always ask how you are feeling to set expectations and ease any potential anxiety. We will also take your vital signs in order to set a baseline.

Next comes the intake process, where we will ask you simple questions such as, "Are you on any non-fertility medications?" or "Do you have any allergies?" This check-in allows us to honor any medical accommodations you may need.

During Your Procedure

Depending on which procedure you are scheduled for (hysteroscopy, laparoscopy, D&C, embryo transfer, or egg retrieval) and various individual factors, the length of your procedure will vary. However, most procedures take around 30 minutes to complete.

If you are having an embryo transfer, you will be awake during the procedure. Your physician will explain everything that's happening and show you exactly when and where your tiny embryo is transferred to your uterus. Embryo transfers are not painful for the vast majority of patients as there is only a thin, flexible catheter inserted into the vagina (aside from the speculum). Some very mild cramping or a slight twinge may be felt by some patients.

For all other surgical procedures, you will be comfortably asleep throughout.

After Your Procedure

As soon as your procedure is finished, you will be moved to your recovery suite, where you will slowly wake up from the anesthesia and remain for around 30 minutes. Your nurse will monitor your vital signs and offer you a snack and a drink.

We will assess any discomfort (if necessary), review your discharge instructions and next steps with you, and answer any questions you may have. Recovery usually goes very smoothly. Finally, we will escort you back to your partner or support person.

Can my partner/support person stay with me? Our current policies allow for one partner/support person to accompany you for your embryo transfer. For all other surgical procedures (including egg retrievals, hysteroscopy, D&C, etc.) your partner/support person is welcome to wait for you in the waiting room. 

What to Expect: Post-Op Care

You will receive individualized instructions after your procedure and be able to discuss any questions or concerns with your nurse prior to leaving our surgical suite. The following are some standard guidelines for what to do (and what not to do) after your procedure. 

For Egg Retrievals

• You will be instructed to take the entire day of your egg retrieval off to rest.
• No heavy lifting - your ovaries are enlarged from being stimulated, so we want to limit twisting activities (such as Cross Fit) for a couple of days until your ovaries shrink back down to their normal size.
• No driving or drinking alcohol due to the anesthesia in your system.
• We suggest drinking electrolyte water to reduce bloating and stay hydrated.
• The day after your procedure, you can go back to work.
• Tylenol is acceptable right after your procedure.
• Heating pads are encouraged to reduce cramping after.
• Most patients wake up pretty comfortable from their retrieval, with only mild cramping.
• You will take an oral antibiotic called doxycycline to prevent infection. This will be a 5-day course of pills that you take twice a day. 

For Fertility Surgeries (i.e. Hysteroscopy)

• You will be instructed to take the entire day off to rest.
• No driving or drinking alcohol due to the anesthesia in your system.
• The day after your procedure you can go back to work.
• Tylenol is acceptable right after your procedure.
• Heating pads are encouraged to reduce cramping after.
• Typically, no discharge medications are needed. 

For D&C Procedures

• You will be instructed to take the entire day off to rest.
• No driving or drinking alcohol due to the anesthesia in your system.
• The day after your procedure you should be (physically) able to go back to work. However, we encourage you to take additional time off if you feel it is needed. 
• Tylenol is acceptable right after your procedure. Tell your Care Team if you have any severe pain or other concerns after your D&C.
• Heating pads are encouraged to reduce cramping after.
• You will take an oral antibiotic called doxycycline to prevent infection. This is a one-time dose of two pills taken with a meal within two hours of your procedure.

For Embryo Transfers

Understandably, many patients have questions about what to do (or not do) following their embryo transfer. Our team has put together a series of guides to help address any concerns you may have about this big milestone in your family-building journey!

• Embryo Transfer Day 101: Everything You Need to Know
• 6 Things Everyone Wonders About Embryo Transfer
• What to Expect at Your IVF Embryo Transfer | A Nurse’s Perspective
• What to Expect at Your IVF Embryo Transfer | A Patient’s Perspective

Considering IVF?

Download our free guide to IVF to learn more about how much it costs, how long it typically takes, and how this fertility treatment can help you.

Fertility Surgery FAQs

Let's answer some commonly asked questions about fertility surgery:

What kind of anesthesia do you use?

All procedures (aside from embryo transfer) are performed under what's called "twilight anesthesia." Anesthesia medications are administered via an IV, ensuring that patients remain comfortably asleep the entire time. The anesthesia we use is short-acting, so you will wake up soon after the anesthesiologist stops your IV and begin the recovery process.

Can I take my medications as usual (even though I am not supposed to have anything to eat or drink before the procedure)?

The answer is usually yes! You can take certain medications pre-approved by your nurse or physician the morning of your procedure with a sip of water, unless otherwise directed.

What if something goes wrong during my procedure?

Our surgical procedures are highly controlled. We perform procedures seven days a week, which means our team is highly experienced and prepared to navigate any issues. There are many checks and balances in place to ensure the safety of our patients.

For example, if a surgeon wants a second opinion regarding the safest way to access a patient's ovaries during an egg retrieval, they have the option of calling in one of the other surgeons in the office for a quick consult. We always at least one additional surgeon in the office should the need for this arise. 

How long will I be at Illume Fertility on the day of my procedure? 

We will request that you arrive one hour prior to your planned surgery in order to allow our team time to properly prep you. Each procedure takes around 30 minutes, followed by around 30 minutes in our surgical recovery area. You can expect to be in our office for around 2 1/2 hours total on your procedure day.

Will I be awake during my procedure?

With the exception of embryo transfers, all patients receive anesthesia medication through an IV in order to keep them comfortable and pain-free during procedures. We use what is called "twilight anesthesia" which is light sedation. Most patients wake up feeling like they've just had the best nap of their lives!

Will someone need to drive me to/from my procedure or can I do it alone?

For any procedure that is performed under anesthesia, you will need your partner or support person to drive you to and from the office. Embryo transfers are not performed with anesthesia, therefore arranging a ride is not necessary. However, you are always welcome to bring one support person with you for your embryo transfer.

What We Want Patients to Know

It's easy to feel isolated during this journey, but we want you to know that you are not alone.

There's always another fertility patient in the next recovery suite going through a similar experience, and our surgical suite is filled with people who care about you. Remember that your entire team is here to support you and we're all working together to help you achieve your goals and dreams.

Don't be afraid to ask questions, voice your concerns, or tell us if you're feeling anxious before your procedure. We are all here to help, and want you to feel as comfortable as possible!