Endoscopy is a minimally invasive surgical technique used in infertility diagnosis and treatment . It includes diagnostic (to inspect pelvic organs) as well as operative ( to treat abnormalities by surgical procedures ) Laparoscopy and Hysteroscopy.

• What are the advantages of Endoscopy ( Laparoscopy and Hysteroscopy )?

Laparoscopy allows direct visualisation of abnormalities (in fallopian tubes, ovaries, outer surface of uterus and pelvis) that might interfere with a woman’s ability to conceive . It also gives opportunity to treat these problems at same setting  ( eg. Adhesiolysis, Cystectomy, PCO drilling, Myomectomy, Fulguration of endometriotic spots etc).

Hysteroscopy allows direct visualisation of abnormalities inside of the uterus which might interfere with implantation. It also possible to treat these abnormalities in same setting ( eg. Septoplasty, Adhesiolysis, Myomectomy , Poplypectomy etc).

• When is Laparoscopy advised ?
• Symptoms suggestive of pelvic infections, history of previous pelvic surgery or previous ectopic pregnancy
• Symptoms suggestive of Endometriosis ( Dysmenorrhea, Dyspareunia, Chronic pelvic pain)
• Abnormal tubal tests ( SIS/ HSG)
• Suspicion of genital tuberculosis
• Unexplained Infertility
• Repeated IUI failures (generally 2 to 3 cycle failure)

Peritoneal factors (endometriosis, pelvic/adnexal adhesions) may cause or contribute to reproductive failure. Laparoscopy with direct visual examination of the pelvic reproductive anatomy is the only method available for specific diagnosis and treatment of otherwise unrecognized peritoneal factors.

Normal Female Reproductive organs on Laparoscopy:

Enometriotic spots :

PCO Drilling :

Hydrosalpinx :

Pelvic Adhesions :

• When is Hysteroscopy advised ?
• Suspected uterine anomalies ( eg. Septate uterus , Bicornuate uterus etc)
• Intrauterine adhesions
• Submucous fibroid
• Intrauterine polyp
• Repeated implantation / IVF failures

Normal Hysteroscopy View ( Inside of the womb):

Intrauterine Septum :

Submucous Fibroid :

Intrauterine Polyp :

Intrauterine Adhesions (Asherman’s Syndrome) :