Laparoscopy - What is it and how does it relate to infertility?

Laproscopy is a medical procedure which allows a physician to view the abdominal and pelvic organs including the uterus, fallopian tubes, ovaries, liver, gall bladder, intestines and even the appendix.  Laproscopy is done through the insertion of a narrow telescope-like instrument through a small incision in the belly button.  The process is minimally invasive and most patients can be discharged the same day of their surgery.  Laproscopy may be diagnostic (used to observe or diagnose a problem) or operative (in which the physician can correct abnormalities encountered during the procedure.)  Laproscopy is typically done under a general anesthetic in the U.S. 

Laproscopy may be used to help diagnose infertility.  Conditions that impair fertility such as endometriosis, uterine fibroids and tubal disease may not have symptoms that a woman notices in her daily life.  Once encountered through the laparoscope many of these conditions can also be treated at the time of their diagnosis.  Typically such a procedure involves the insertion of additional narrow instruments at the top of the pubic hair line in the lower abdomen.

Due to the cost and invasive nature of laparoscopy it is generally not the first procedure or diagnostic test performed as part of the couples' infertility diagnostic evaluation.  Semen analysis, hysterosalpingogram and documentation of ovulation are typically examined prior to consideration of laparoscopy.

There are some complications that may be associated with laparoscopy.  They include include the possibility of damage to other structures in the pelvis such as the bladder, ureter, bowel and blood vessels.  And of course any surgery can have an anesthesia-related complication or be associated with post-operative infection, such as a skin infection at an incision site.

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