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Laparoscopy and hysteroscopy in fertility

Laparoscopy is a surgical procedure, done under general anaesthetic, that involves making some very small cuts in the abdomen, through which a laparoscope and specialized surgical instruments can be inserted. A laparoscope is a thin, fibre-optic tube, fitted with a light and camera attached to a television screen.

Laparoscopy allows your doctor to see the pelvic organs and sometimes make repairs, without making a larger incision that can require a longer recovery time and hospital stay.
For the patient suffering from infertility, laparoscopy may be used to make a diagnosis or perform surgery. A diagnostic laparoscopy may be performed to find a possible cause for infertility such as blocked tubes, the presence of scar tissue or adhesions or to make the diagnosis of endometriosis.
While viewing the pelvic organs through the laparascope, a blue dye can be injected into the uterus from below. When the dye enters the tubes, it may either pass through them into the abdominal cavity, indicating that the tubes are open, or show where a blockage exists.

Endometriosis can be seen very clearly and shows up as purple coloured patches that may be spread throughout the pelvis. Similarly, scar tissue or adhesions may be seen in positions that interfere with the normal passage of an egg into the tubes
Operations to treat a cause of infertility are performed by laparoscopy, including the removal of adhesions and scar tissue, laser surgery to destroy patches of endometriosis, removal of ovarian cysts and even infected Fallopian tubes.

Hysteroscopy is a procedure where a tubular scope is placed through the vagina into the uterus, usually with the patient under anaesthesia. It is used in the study of infertility, recurrent miscarriages or abnormal uterine bleeding. After the cervix is dilated, the uterus is filled with fluid in order to see the uterine cavity and its lining. Abnormalities in the uterus, such as polyps, fibroids or adhesions, or a septum can be visualized and by the use of small instruments, corrective surgery can be performed at the same time as the diagnostic procedure. All of these abnormalities may interfere with the implantation of an embryo into the uterine lining or cause an early miscarriage so their removal can be an important step in curing infertility.

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