Laparoscopy to Diagnose Fertility Issues

A laparoscopy, like a hystersalpinogram (HSG), is a test used to find obstructions in your fallopian tubes. It's far more high-tech and much riskier than an HSG, but can provide extremely detailed information.

Here's how it works: your doctor will insert a fiber-optic scope into your abdomen to look for signs of damage caused by endometriosis, pelvic inflammatory disease, or adhesions from pelvic surgery, and to look for physical evidence of ovulation.

You'll be put under general anesthetic during the procedure, and you may experience degrees of soreness in your abdomen and shoulders afterward.

Note: If your doctor suggests that you have a D & C (dilation and curettage) done simultaneously with your laparoscopy, look for a second opinion. Studies have proven that D & C procedures provide no more insight than what can be learned through a less-expensive, less-hazardous endometrial biopsy. Put on the brakes if your doctor wants you to have a laparoscopy right away, too: As a rule of thumb, you should wait six months after your HSG—assuming, of course, that it was normal—so you can take advantage of the fertility-enhancing effects of HSG. Obviously, if your doctor believes you have endometriosis or severe pelvic adhesions—or if you are over the age of 40—a waiting period may not make sense.