Surgical Tests: Hysteroscopy and Laparoscopy

If blood tests and other diagnostic tests do not determine the cause of your infertility, your health care professional may suggest one or two surgical tests to try to diagnose or treat the problem. One test lets the doctor see inside the uterus and the other shows the outside of the uterus, the ovaries, and fallopian tubes.

You and your fertility doctor will decide which test is right for you based on your medical history and symptoms. In some cases, both procedures are done at the same time in an effort to find the cause of your infertility.

Hysteroscopy

A hysteroscopy gets its name from the thin telescope-like viewing device, called a hysteroscope, which is used during the procedure to let the doctor see inside your uterus. Usually performed by your reproductive endocrinologist (RE), a diagnostic hysteroscopy is done in office, without anesthesia. The procedure takes about 10 minutes but could take longer if the doctor finds something that can be corrected at the same time. (An operative hysteroscopy is done if there’s evidence of fibroids or polyps that need to be removed. This is an out-patient procedure in a hospital or surgery center.)

A hysteroscopy is used to see if your fertility problems are due to scar tissue or to problems with the shape or size of the uterus due to fibroids or polyps. It may also determine the cause of repeated miscarriages.

During the test, the doctor is able to not only find, but to treat, several other problems. For example, s/he can remove any small fibroids or polyps s/he finds during the procedure. The doctor may also be able to stop abnormal bleeding or remove a blockage in the fallopian tubes. If there are problem areas in the endometrial lining of the uterus, the doctor can remove them.

Laparoscopy

A laparoscopy uses a small telescope-like tube called a laparoscope to let the doctor see the outside of your uterus, ovaries, and fallopian tubes. A laparoscopy takes about 30 to 90 minutes but can take longer if the doctor finds something that can be corrected at the same time. It is usually done under general anesthesia, and most women go home the same day.

The test determines if there is a blockage in the fallopian tubes or if you have endometriosis or scar tissue that could be causing fertility problems. This procedure also allows the doctor to find and treat conditions such as endometriosis or pelvic inflammatory disease (PID, a pelvic infection which can cause infertility).