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Gynaecology ::

Laparoscopic Ovarian Diathermy

Laparoscopic surgery is carried out for patients with Polycystic Ovarian Syndrome (PCOS). PCOS patients with large ovaries that have difficulty in responding to routine ovulation induction may benefit from laparoscopic ovarian “drilling”. Small “holes” are made in the ovaries via the Laparoscope. This procedure can improve the response to gonadotrophins.

Laparoscopy

This is an endoscopic (keyhole) procedure to check the pelvic organs and the inside of the uterus to exclude any abnormalities. This usually requires anaesthesia and is carried out as day-care operation

Hysteroscopy

The removal of intrauterine polyps (‘finger-like’ growths on the lining of the womb) is carried out using a hysteroscope. Also, uterine fibroids projecting into the uterine cavity and intrauterine adhesions can be resected.

Colposcopy

A colposcope is a telescope that is used to magnify the cervix and check for any abnormal changes. It is indicated when the Cervical Smear shows abnormalities. The abnormal area usually shows a pattern consistent with pre-cancerous changes and this can be “biopsied”.
 

Embryo Freezing

The freezing of human embryos has recognized benefits for patients who undergo Assisted Reproductive Treatment.  The extra embryos (those left over after the transfer of fresh embryos) can be frozen and have been known to be viable for up to 10 years.  The benefit of transferring these embryos in a natural, or articifial endometrial cycle is the fact that no stimulation of the ovaries is required.  The latter is the major reason why patients are hesitant to have repeated attempts at conception.

The DG&FC has been freezing embryos for the last 9 years and we have had a reasonably good result with the transfer of these frozen embryos.  Our best pregnancy rates with frozen embryos are up to 25% per transfer.  However, not all embryos are suitable for freezing.  Even good grade embryos do not always survive the freezing and thawing process.  The average survival rates of frozen embryos is about 40 – 60%. 

To transfer frozen embryos in patients with regular periods, the ovarian follicular growth is monitored by ultrasound and once ovulation is confirmed, embryos are usually transferred after 2-3 days.  In patients that do not have regular periods, Decapeptyl is used to control the cycle and Estrogen (Progyluton) is used to develop the endometrium.  When the endometrium is ready, then Progesterone (Cyclogest) is commenced and the embryos are transferred after 3 days.

There is a charge for the freezing and maintenance of embryos and a separate charge for the frozen embryo transfer.  These are included in the Price List. 

It is important that couples with frozen embryos keep the Centre informed of their intentions with regards to the future use of these embryos.  If there is no future intention to use the embryos, then authorization needs to be given to have them disposed of.  A written consent by both husband and wife will be obtained prior to their disposal. 

The annual maintenance fee will be payable on demand when the couple plan to transfer frozen embryos.

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