This procedure allows us to determine whether there are any defects such as scar tissue, endometriosis, fibroid tumours and other abnormalities of the uterus, fallopian tubes and ovaries.Laparoscopy allows your doctor to see the abdominal organs and sometimes make repairs, without making a larger incision that can require a longer recovery time and hospital stay.
If any defects are found then they can sometimes be corrected with operative laparoscopy which involves placing instruments through ports in the scope and through additional, narrow (5 mm) ports which are usually inserted at the top of the pubic hair line in the lower abdomen.
Whether or not diagnostic laparoscopy should be done in females with infertility is controversial. Because of the cost and invasive nature of laparoscopy, it should not be the first test in the couples diagnostic evaluation. In general, semen analysis, hysterosalpingogram, assessment of ovarian reserve and documentation of ovulation should be assessed prior to consideration of laparoscopy. For example, if the woman has a clear ovulation problem or her male partner has a severe sperm defect then it is unlikely that laparoscopy will provide additional useful information that will help them conceive.
Laparoscopy was part of the standard female infertility work up until the mid-1990’s. Before then most reproductive endocrinology and infertility specialists did laparoscopy prior to using gonadotropins for superovulation of the ovaries as a fertility treatment. However, this tradition has been challenged as being of questionable benefit when assessed by its cost-effectiveness and invasiveness.
Fertility clinics are doing far less diagnostic laparoscopy today than in the 1980’s and 1990’s. Much of this is due to the major advances in IVF technologies and the resulting increases in IVF success rates. Couples are carefully considering the costs of fertility treatments for women. They are asking for insemination treatments and in vitro fertilization, but are usually not interested in having diagnostic surgery.
But there are certain indications which make Laparoscopy worth doing in case of infertility .
- Unexplained infertility.
- Females with sever PCOS not responding to medical management .
- Endometriosis moderate to sever grade .
- Tubal blocks on HSG or SSG.
- Congenital birth defects in Uterus , ovaries or tubes etc. like double uterus, septum in uterus unicornuate uterus etc.
- any cyst , tumor or polyps in uterus or ovaries.