Hysteroscopy and laparoscopy are the gold standard in the treatment and the evaluation of the infertile couple. Basically what do we understand by laparoscopy and hysteroscopy is laparoscopy is a minimally invasive surgery where we make a very small cut in the umbilicus and make small holes, maybe 3 mm or 5 mm hole to access the abdominal cavity and we put in a camera, which is connected to the TV and we visualize the internal organs, mainly the uterus, the tubes and the ovaries. We do this to see why the patient hasn’t conceived all this time. In case there are any difficulties seen in the laparoscopy, it can be treated in the same time. If they have been married for a very long time and we see the if the pelvic organs or intestine being stuck to each other, we try to release it and if the tubes are locked, we do tubal canalization, which momentarily releases tubal block and other ovarian conditions can be assessed like a ovarian cyst or endometriotic cyst, or if they have polycystic ovaries, we do ovarian drilling, where we drill in the ovary, so that the hormone levels increase, which in turn results in pregnancy. Hysteroscopy is a scopy, where we insert a tube inside the uterus, basically a cameras in the uterus and see how is the uterine cavity, and how is the shape of the uterine cavity. If it is normal, and if we have abnormalities like this in the uterine cavity, then people might have difficulty to conceive or they can have delay in pregnancy or if they are pregnancy, they could be losing out on pregnancy and what we asses in hysteroscopy is how are the tubal openings located and how is it seen. If the tubal openings are seen on both sides then we can say the cavity is entirely normal. Sometimes in very rare situations, only one side tubal openings are seen and they require much more evaluation if it is treatable during hysteroscopy that can be done. Hysteroscopy is a very important procedure and it is done before IVF to assess the uterine cavity. Sometimes there are extra growths in the uterus called endometrial polyps, it could be a soft polyp or hard polyp, like a fibroid. So this requires removal. Otherwise it results in IVF failure. Hysteroscopy and laparoscopy is a short procedure done under general anesthesia. It is a day care procedure where morning they get admitted and evening the get discharged. None of the patients should undergo any pain during any of the treatment procedure. So any patient cannot feel any pain of hysteroscopy or laparoscopy since it is done under anesthesia. HSG is a fairly painful procedure but hysteroscopy and laparoscopy isn’t.

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