Laparoscopy or keyhole surgery is done in specific indications in infertility, it is not indicated in all cases of infertility. It can be done as a diagnostic procedure or a therapeutic one. Diagnostic is when we have to diagnose if there is any cause inside the uterus or outside the uterus like in the tubes or ovaries which can cause fertility issues. When we do a laparoscopy we try to look at the issues the tubes the ovaries, if there are any tubo ovarian alterations, especially the tuboovarian relation, if the tubes are patent, if the tubes are normal looking there is any mild endometriosis or if there is any hysteroscopy where we try to visualize the interior of the uterus where we try to look at the adhesions or polyps or fibroids in the same sitting these can be tackled. Lot of therapeutic procedures are done. There is a tubal block, that can be opened with a laparo hysteroscopy procedure. If there is a cyst, that is an endometriotic cyst, more than 4 cms, cystectomy or cyst removal can be done if there is a fibroid, more so in a location that can cause infertility, then if they are big and more than 4 cms in size, and they require removal, that also can be done laparoscopically. Or if there is any endometrial lesions that need to be abalated, or any restoration of the pelvic anatomy, all these thing can be done by laparoscopy. Lot of hysteroscopy procedures can be done especially septal resections. You see there is a septa in the interior of the uterus, that can be cut. If there are polyps they can be removed, of there are adhesions they can be removed. So laparoscopy and hysteroscopy in infertility to diagnose a lot of conditions as well as treat so mainly these procedures are aimed at restoring fertility and most of these are day care procedures.

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