Laparoscopy for an unful­filled desire to have chil­dren can be use­ful to iden­ti­fy pos­si­ble caus­es of infer­til­i­ty. In par­tic­u­lar, endometrio­sis or fibroids can be detect­ed dur­ing laparoscopy. These con­di­tions are among the most com­mon rea­sons for invol­un­tary child­less­ness. The ben­e­fits and risks of this pro­ce­dure should be care­ful­ly weighed. At our pri­vate cen­ter “Die Kinder­wun­schärztin” in Munich, we pro­vide our patients with detailed coun­sel­ing before laparoscopy.

• When is laparoscopy advis­able when try­ing to con­ceive?
• How does laparoscopy work?
• What you should keep in mind after laparoscopy
• Costs of laparoscopy when try­ing to con­ceive

When is laparoscopy advis­able when try­ing to con­ceive?

Laparoscopy is per­formed pri­mar­i­ly when adhe­sions, scar tis­sue, or endometrio­sis are sus­pect­ed. This is because laparoscopy allows the uterus, fal­lop­i­an tubes, ovaries, and oth­er organs to be assessed very well. One advan­tage of laparoscopy is the abil­i­ty to exam­ine the abdom­i­nal cav­i­ty for changes that may be pre­vent­ing preg­nan­cy. In addi­tion, minor treat­ments can be car­ried out immediately—often avoid­ing the need for anoth­er pro­ce­dure.

In prin­ci­ple, laparoscopy can also be used to check whether the fal­lop­i­an tubes are open. How­ev­er, there are now gen­tler meth­ods to assess this. For this rea­son, in such cas­es laparoscopy is only very rarely per­formed at our fer­til­i­ty cen­ter. The so-called HyCoSy pro­ce­dure is usu­al­ly the bet­ter alter­na­tive.

How does laparoscopy work?

A laparoscopy of the abdom­i­nal cav­i­ty always begins with a detailed con­sul­ta­tion with our physi­cians. In most cas­es, we first per­form an ultra­sound exam­i­na­tion and a phys­i­cal exam­i­na­tion to clar­i­fy whether laparoscopy is actu­al­ly nec­es­sary. Although this is a very safe and well-estab­lished pro­ce­dure, gen­er­al anes­the­sia is still required. If blocked fal­lop­i­an tubes are sus­pect­ed, we can also assess this using the HyCoSy pro­ce­dure.

The entire treat­ment is per­formed under gen­er­al anes­the­sia, mak­ing the pro­ce­dure as com­fort­able as pos­si­ble for you as a patient. If the paten­cy of the fal­lop­i­an tubes is to be checked as part of laparoscopy, a harm­less dye is intro­duced into the uterus. A tiny cam­era is then insert­ed into the abdom­i­nal cav­i­ty through a small inci­sion at the lev­el of the navel. If the fal­lop­i­an tubes are open, this is indi­cat­ed by the blue dye flow­ing out. If one or both fal­lop­i­an tubes are blocked, they can usu­al­ly be opened direct­ly dur­ing laparoscopy (at least tem­porar­i­ly) to enable preg­nan­cy in cas­es of an unful­filled desire to have chil­dren.

If endometrio­sis, adhe­sions, or oth­er benign con­di­tions are sus­pect­ed, the physi­cian exam­ines the organs in the abdom­i­nal cav­i­ty using the small cam­era. In this way, even very small endometrio­sis lesions in the woman’s body can be detect­ed and usu­al­ly removed. Ovar­i­an cysts or fibroids are also treat­ed.

Hys­teroscopy

In most cas­es, an addi­tion­al hys­teroscopy is advis­able. Access is usu­al­ly gained through the vagi­na into the uterus. This allows us to reli­ably detect changes in the uterus, such as a polyp, and usu­al­ly treat them imme­di­ate­ly. This step is par­tic­u­lar­ly use­ful if a pre­vi­ous ultra­sound exam­i­na­tion was abnor­mal.
Laparoscopy usu­al­ly takes only 30 min­utes. How­ev­er, if endometrio­sis lesions and oth­er changes in the woman’s abdom­i­nal cav­i­ty need to be treat­ed dur­ing the pro­ce­dure, it can take up to two hours.

Costs of laparoscopy

You will receive the exact costs of laparoscopy in the con­text of fer­til­i­ty treat­ment dur­ing your con­sul­ta­tion at the pri­vate cen­ter Die Kinder­wun­schärztin.

What you should keep in mind after laparoscopy

Laparoscopy is usu­al­ly per­formed on an out­pa­tient basis. Take it easy in the days after the pro­ce­dure and do not lift heavy objects. Walks in the fresh air are a good way to get your cir­cu­la­tion going—however, you should avoid sports dur­ing the first few days.

After laparoscopy, a small scar remains in the area of the navel. On the third day after the pro­ce­dure, you may show­er care­ful­ly. How­ev­er, be sure to cov­er the wound with a water­proof dress­ing. Foods that cause bloat­ing can also be uncom­fort­able in the first few days after the exam­i­na­tion. If you expe­ri­ence post-oper­a­tive bleed­ing, fever, or severe pain, you should see a doc­tor imme­di­ate­ly.