Laproscopy

Laparoscopy for infertility is a minimally invasive surgical procedure that uses a laparoscope (a fiber-optic tube with light and video camera) inserted through two or more minor incisions, often in the belly button. The surgeon can then visually examine the pelvic reproductive organs and the pelvic cavity. The procedure is part of fertility testing, the doctor is evaluating the structures of the reproductive system, including the Uterus, Tubes, ovaries, Tubo-ovarian relation patency of fallopian tubes .

Laparoscopy allows the fertility doctor to see other abnormalities that might interfere with a woman’s ability to conceive a pregnancy. The most common problems are endometriosis , pelvic adhesions , ovarian cysts and uterine fibroids , polyp ,genital tuberculosis.

. It can be simultaneously used as a diagnostic procedure as well as corrective procedure. In many cases where no aetiology of infertility is found called Unexplained infertility, it can be useful to identify infertility factors difficult to be picked up by routine investigations (mild endometriosis, adhesions).

Genital tuberculosis is common in India so it is very important to do laparoscopy and find out hidden causes like tuberculosis which may be leading to infertility. Sometimes when tuberculosis is detected as cause of infertility, treating the patient with 8-9 months of antitubercular drugs improves the outcome.

Many times, it is used as a corrective procedure in infertility when women present with multiple fibroids (Myomectomy), huge endometrioma (drainage & removal), large adenomyotic uterus (myo reduction of uterus) and enlarged fluid filled tube called Hydrosalpinx (removal or clipping). These procedures are carried out prior to undergoing IVF/ART.

Generally, laparoscopy should be reserved for couples who have already completed a more basic infertility evaluation including assessing for ovulation, ovarian reserve , ultrasound and hysterosalpingogram for the female and semen analysis for the male.