Infertility investigations by laparoscopy

Laparoscopy is a procedure used to diagnose causes of infertility and can often treat  these causes. The following article explains what happens before and during a  laparoscopy and how it is used to investigate and treat infertility. 

Laparoscopy is a surgical procedure that allows us (doctors) to see inside the body. When the procedure is part of fertility testing, we will be evaluating the structures of the reproductive system, including the ovaries, Fallopian tubes, uterus, and cervix.
Laparoscopy can help us diagnose many conditions that affect fertility, such as:
 - endometriosis
 - blocked Fallopian tubes
 - build-ups of scar tissue
 - fibroids and
 - other abnormalities of the reproductive system
Laparoscopy can also help when a patient has unexplained infertility. This is the diagnosis when results of other diagnostic tests were normal, but patient is still unable to conceive.
By looking at the reproductive organs, we may be able to identify conditions that are preventing conception and are otherwise undetectable.
PROCEDURE
A laparoscopy is a simple outpatient procedure. A patient can undergo it in:
 - a hospital
 - an outpatient surgical centre
Patient will receive anaesthesia before the procedure, so they will not be awake or able to feel pain.
After giving them the anaesthesia, the laparoscopic surgeon will:
 - insert a port into the abdomen
 - inject gas into the abdomen, to make it easier to see the organs and structures
 - insert a small camera on an instrument called a laparoscope through a tiny incision
 - make a second incision and insert a small tool called a probe
With the camera, the doctor will examine the structures in the abdomen. They will use the probe to move or lift organs out of the way.
Depending on what the doctor sees, there may be other steps, including:
 - injecting dye through the Fallopian tubes to see if they are open for sperm and eggs to travel through
 - attempting to open blocked Fallopian tubes
 - removing scar tissue or adhesions
 - correcting abnormalities
 -  removing a cyst or endometriosis
 -  performing procedures to correct polycystic ovaries
We may make a third incision in the abdomen and insert instruments to perform these additional procedures.
Finally, we will remove the tools and stitch up the incisions.
Patient will have to remain under observation for a few hours to make sure that there are no complications and that recovery is going well.
Anyone who has undergone a laparoscopy should have someone else drive them home. Also, someone should stay with them for up to 24 hours after surgery.
SIDE EFFECTS
Some pain and discomfort are common after surgery, though it should be minimal.
A person may experience pain in the shoulders or abdomen as the injected gas starts to dissipate.
It can take a few hours, and up to a day to relieve all the gas and discomfort. Walking around and drinking peppermint tea can help.
While rare, complications can occur after surgery. Anyone experiencing any of the following complications should contact the doctor right away or head to the nearest emergency room:
 - high fever
 - heavy bleeding
 - worsening or severe pain
 - infection of the incisions, including redness, swelling, or discharge
 - being unable to use the bathroom
BENEFITS
Compared to other surgical procedures that can help a doctor diagnose the cause of infertility, a laparoscopy involves:
 - less invasive methods
 - a lower risk of infection
 - tinny scars
 - the possibility of correcting the issue during surgery
 - an easier recovery
 - also, if a person receives treatment during the procedure, the chances of conceiving may increase right away.
RISKS
As with any surgical procedure, it is essential to consider the risks. Risks associated with laparoscopy include:
 - internal bleeding
 - infection
 - poor healing at the incision sites  
 - very rarely, damage to the internal organs
Laparoscopy is one of diagnostic tool for women with unexplained infertility. The increased use of assisted reproductive technologies, such as in vitro fertilization (IVF), has led some doctors to recommend IVF right away, before laparoscopy. We recommend considering laparoscopy first.
TAKE HOME MESSAGE
In many cases, we, doctors can diagnose and even repair any issues during the laparoscopy. After the procedure, we will describe the results, show photos taken during the surgery and present some possible next steps.
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Original article published in MedicalNewsToday