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When It's Time for Fertility Testing

What Happens Next?

The next phase of testing may include a laparoscopy, which involves looking at the woman's reproductive organs by means of an operative procedure. This procedure is usually done four to six months after the HSG. However, if your healthcare provider doesn't believe that you have significant endometriosis or adhesions based on the previous testing, he or she may recommend bypassing this surgical procedure and moving to other treatments.
This surgical procedure is done under general anesthesia and is usually performed around or before ovulation. This procedure is usually done in an outpatient surgical center. A laparoscopy allows your healthcare provider to have a clear view of your pelvic cavity, including the ovaries, uterus, and fallopian tubes. If adhesions or endometriosis is identified, a laser can be used to remove them. In some cases, your healthcare provider may combine the laparoscopy with a hysteroscopy. 
During the procedure, a small incision is made in the navel (belly button) and a telescopic device is placed through the incision to look at the reproductive organs. Another small cut is made in the pubic hairline to insert another instrument that is used to move the organs around. Carbon dioxide gas is used in the abdomen (stomach) to expand the area and help your healthcare provider see the organs more clearly. The use of carbon dioxide can cause a bloated feeling and shoulder pain for a few days.
A laparoscopy can come with some rare surgical risks, such as bleeding or injury to the bowel or bladder. However, these risks are small, and the recovery period is usually just a few days.
Last reviewed by: Arthur Schoenstadt, MD
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