A laparoscopy forms the cornerstone for the surgical evaluation of the pelvis of an infertile woman after a basic infertility investigation is completed. In some cases where endometriosis, pelvic inflammatory disease, or pelvic pain needs evaluation, it may be indicated earlier in the evaluation. The laparoscopic procedure is sometimes combined with a hysteroscopy when indicated.
Laparoscopy is performed under general anesthesia in a surgical center. A small needle is inserted into the abdominal cavity and C02 gas is introduced. The laparoscope (a telescope with a strong light and camera) is introduced through the navel. A variety of instruments can be inserted into the pelvis, through other small incisions, to perform diagnostic and corrective surgery. This procedure allows the physician to visualize the internal organs where reproduction occurs.
A hysterosalpingogram or HSG is an important test of female fertility potential. The HSG test is a radiology procedure usually done in the radiology department of a hospital or outpatient radiology facility. Radiographic contrast (dye) is injected into the uterine cavity through the vagina and cervix.
The uterine cavity fills with dye and if the fallopian tubes are open, dye fills the tubes and spills into the abdominal cavity. This shows whether the fallopian tubes are open or blocked and whether a blockage is at the junction of the tube and uterus (proximal) or at the other end of the tube (distal).