Laparoscopy and hysteroscopy | New Orleans Fertility Institute (2023)


  • Overview (jump to it): Fertility surgery can help infertile individuals or couples with specific reproductive problems that more commonly affect women.
  • program: We perform most infertility procedures with minimally invasive procedures that do not involve incisions (hysteroscopy) or small incisions (laparoscopic/robotic), which results in faster patient recovery.
  • Laparoscopy:This type of minimally invasive surgery uses a small incision in the abdomen to insert a laparoscope (a small fiber optic tube with a light and camera) to diagnose the problem and use small surgical instruments to correct the problem.
  • hysteroscopyIt has a similar function, but instead of an incision in the abdomen, a hysteroscope is inserted through the cervix and into the uterus to diagnose and treat problems. This is an office procedure and recovery is relatively quick for most patients.
  • risk: Like any surgical procedure, minimally invasive surgery carries the risk of blood loss, blood clots, scar tissue, and pain. The most serious complications are rare.
  • Our providers thoroughly discuss all benefits/risks and all aspects of family planning surgery with patients, answering all questions and addressing any concerns.

What are laparoscopic and hysteroscopic fertility surgeries?

Fertility InstituteDoctorMinimally invasive procedures are often used to diagnose and treat conditions that may interfere with a woman's ability to conceive or maintain a pregnancy. For more complex surgical situations, we can use robotic surgery. The two most common operationsSterilityLaparoscopy and hysteroscopy can both diagnose conditions and treat them during the same procedure.

When conditions cannot be repaired by these minimally invasive means, we use traditional open surgery or laparotomy, which involves larger incisions.

Other doctors often send us stories about their difficult infertility surgeries. FINO is Louisiana's premier infertility clinic with trusted experts.

Infertility problems or conditions diagnosed or treated by laparoscopy and hysteroscopy

  • Abnormalities of the uterus or ovaries.
  • Fallopian tubes are blocked.
  • Adhesions (vascular tissue).
  • ectopic pregnancy.
  • Ovarian cyst.
  • Uterusfibroids.
  • ENDOMETRIOSIS(The diagnosis can only be confirmed by laparoscopy.)

More information about the causes of infertility

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Minimally invasive and robotic surgery

minimally invasive surgeryIt is a surgical procedure that uses small incisions (less than one inch) and special tools. It uses an oscilloscope to project internal images to external monitors.

Minimally invasive surgery means faster surgery, less pain, shorter recovery time and reduced surgical risk compared to "open" surgery with larger incisions.laparoscopy(see below) was one of the first forms of minimally invasive surgery used.

We have access to robotic surgery, which is an advanced, minimally invasive procedure that is often better suited for more complex procedures. This is due to its greater precision and flexibility to run complex programs in very tight spaces. Robotic tools can perform actions that human hands cannot.

Robotic surgery uses a computer-controlled robotic arm operated by a surgeon to perform surgery.

It also provides the surgeon with a 3D view of the operating field on the monitor.

Our specialists for laparoscopy and hysteroscopy

  • Heber E. Dunaway, ml., doktor medicine, F.A.C.O.G.

    dr. Heber E. Dunaway, a fertility specialist, specializes in all infertility treatments and robotic surgery. He believes in honesty and treating patients like family.

  • Warren "Jay" Huber III, MD, PhD

    dr. Warren "Jay" Huber III is board certified in obstetrics and gynecology and board certified in reproductive endocrinology and infertility (REI). dr. Huber specializes in robotic and laparoscopic (minimally invasive) surgery as well as hysteroscopic surgery and is certified in Intuitive Da Vinci Robotics.

laparoscopy for infertility

Laparoscopy is both a diagnostic tool and a surgical tool for infertile women. It involves the use of a laparoscope, a small fiberoptic tube with a light and camera, and small surgical instruments inserted through small incisions in the abdomen.

This allows fertility surgeons to easily diagnose and repair problems with the reproductive organs during the same procedure. The surgeon will make two or more small incisions about a quarter inch in diameter. The first is usually done in the navel, and the second in the lower abdomen.

Laparoscopy usually takes 30 to 90 minutes and is performed under general or local anesthesia. For the best possible examination of the organs, the abdominal cavity is filled with gas that keeps the organs away from the abdominal wall and provides additional space and visibility.

During surgery, doctors may take tissue samples, drain cysts, or repair other structural problems, such as removing adhesions or fibroids. After the procedure is completed, the gas will be removed and the incision will be closed with absorbable sutures.

Laparoscopy and hysteroscopy | New Orleans Fertility Institute (3)
Laparoscopy and hysteroscopy | New Orleans Fertility Institute (4)

When is laparoscopy useful in the treatment of infertility?

Laparoscopic surgery for fertility problems is generally recommended only after all other reproductive imaging tests have failed.

Laparoscopy is also used to treat many conditions that cause infertility, including uterine fibroids, ovarian cysts, and endometriosis.

finer points

What to watch out for when performing laparoscopic surgery

  • Patients must stop eating 12 hours before the procedure.
  • An hour before, the woman should also empty her bladder and receive intravenous (IV) fluids and medication through a vein in her arm.
  • In the operating room, general anesthesia will be given through an IV and the patient will be put to sleep.
  • In preparation for surgery, a breathing tube and/or catheter may be placed. Pubic hair can be shaved.

Hysteroscopy for infertility

A hysteroscopy is performed to diagnose abnormalities that may affect a woman's fertility or cause other gynecological problems. Hysteroscopy is a minimally invasive procedure that involves inserting a hysteroscope (a small tube with a light and camera) through the cervix into the dilated uterus. This allows the doctor to see the uterus and fallopian tubes more directly. No incisions required.

When performing a diagnostic hysteroscopy, the surgeon may decide to correct any finding, turning the diagnostic hysteroscopy into a surgical hysteroscopy. In this case, small surgical instruments are inserted through the hysteroscope to correct problems such as adhesions (scar tissue), fibroids, and polyps.

Patients go home the day of surgery and can usually return to work the next day.

When is hysteroscopy useful for treating infertility?

Hysteroscopy is used to diagnose the cause of uterine abnormalities, such as polyps or fibroids, many of which can lead to infertility. Surgical hysteroscopy can often be used to treat these abnormalities.

Hysteroscopy is usually performed after minimally invasive reproductive imaging techniques have failed to establish a diagnosis.

finer points

What to expect during a hysteroscopy

  • Hysteroscopy is performed with sedation to make the woman feel more comfortable and relaxed during the procedure or under general anesthesia.
  • Before the hysteroscopy, the patient will empty her bladder and put on a gown.
  • The patient will lie on his back on the examination table with his feet in stirrups.
  • The doctor inserts a speculum into the vagina to better see the cervix.
  • The doctor will introduce the hysteroscope into the vagina, through the cervix and into the uterus, which will fill with fluid.
  • After the operation, the patient will be monitored for several hours before going home. You should have someone drive you home.
  • Hysteroscopic surgery should only be performed on women who are not pregnant and are not menstruating. Hysteroscopy on days 6 to 14 of the menstrual cycle (after menstruation but before ovulation) helps to verify that the patient is not pregnant.

exist Fertility treatment at the New Orleans Fertility Institute has helped many people achieve their family goals: 19,000 pregnancies and counting.

Hysteroscopy procedure while awake

dr. Huberexistmetairie positionWe now offer awake hysteroscopy procedures in the office. They differ from traditional hysteroscopies, which sometimes use general anesthesia because there is no anesthesia and minimal discomfort. This type of hysteroscopy is very convenient and very effective.

The procedure usually takes 5-10 minutes from start to finish, but can sometimes be completed in less than 2 minutes, depending on the pathology found. Recovery time is short and most patients can resume normal life soon after surgery. Full recovery is expected within 12 to 24 hours.

Eligible candidates for an awake hysteroscopy include:

  • Patients who require additional imaging for diagnosis.
  • Suspected or known patients with small intrauterine lesions, such as scar tissue in the uterus after abortion or childbirth, placental or fetal tissue, small polyps, etc.

Make an appointment with dr. Huber for awake hysteroscopy.

Risks and side effects of fertility surgery

As with any surgery, surgery to address reproductive problems has inherent risks. These phenomena are reduced when the surgical procedure is performed with minimally invasive procedures. Minor complications include incision infection and skin irritation.

More serious complications may occur in about 1% to 2% of cases, including:

  • Complications of anesthesia (vomiting, nausea, headache, allergic reaction, lung infection).
  • Cicatrization.
  • Nerve damage.
  • Excessive bleeding or blood clots.
  • Hematoma (swelling caused by blood outside a blood vessel).

Although very rare, the surgical tools used can damage the uterus, abdominal wall or other organs. If this happens, the damage will be repaired immediately.


What are the odds of getting pregnant after a laparoscopy? ›

The median time until pregnancy (10.8 ± 9.4) was 8 months. In summary, 27 patients (26.5%) became pregnant during the first 6 months after laparoscopy, and 49 patients (48%) became pregnant during the first 12 months after laparoscopy.

Why am I not getting pregnant after laparoscopy? ›

There are many different issues which can cause pelvic factor infertility. Scar tissue from infections, injuries or surgeries, or problems like endometriosis, ovarian cysts, polyps or fibroids in the uterus can all affect how a woman's reproductive system functions.

What is the success rate of laparoscopy for IVF? ›

Sixty cases (10%) had intrauterine insemination and sixty four cases (10.7%) underwent in vitro fertilization (IVF) / intracytoplasmic sperm injection (ICSI) treatment. Within 1 yr after laparoscopy, 180 cases achieved pregnancy (30%).

Can you get pregnant 1 month after laparoscopy? ›

Yes, it is possible for women to conceive after a laparoscopy. The success rates for laparoscopy for infertility vary depending on your age, and have been seen to be higher in women younger than 35 years.

Does laparoscopy improve egg quality? ›

Laparoscopy is proven effective in improving fertility through surgery on ovaries, pelvic, uterus and fallopian tubes.

Can I conceive naturally after hysteroscopy? ›

Q1. Can I conceive naturally after hysteroscopy? After undergoing a simple hysteroscopy procedure to remove anomalies, you have an excellent chance of getting pregnant either naturally or after specialized fertility treatment and procedures such as IVF and IUI.

How soon after hysteroscopy can you try to conceive? ›

After a hysteroscopy your doctor may recommend that you wait a few weeks or up to three months (for large fibroids) before starting an IVF cycle.

Does laparoscopy reduce egg count? ›

Laparoscopy can lead to injuries in ovarian tissue and induce the reduction of ovarian reserve.

Does laparoscopy affect egg reserve? ›

The results of Candiani M. et al. showed that laparoscopic cystectomy with electrocoagulation was associated with a significant reduction in ovarian reserve after surgery, which was partially a consequence of the damage of the ovarian vascular system (12).

What comes first laparoscopy or IVF? ›

I advise laparoscopy as first line treatment to younger couples with good ovarian reserve who wish to get pregnant naturally or need treatment for pelvic pain. I tell them IVF would most likely provide the shortest time to pregnancy.

Why is laparoscopy done before IVF? ›

Laparoscopy in women with normal hysterosalpingography but recurrent IVF failures can detect unrecognized pelvic pathologies. Laparoscopy evaluation prior to additional cycle of IVF seems to improve the subsequent pregnancy rate.

Can a laparoscopy cure infertility? ›

Laparoscopies for infertility can be beneficial if you have scarring or blockage in the fallopian tubes. This disease is hard to diagnose and treat using other methods of diagnosis. A laparoscope helps the doctor to view and correct blocked or scarred tubes to enhance conception.

How long does it take for your uterus to heal after laparoscopy? ›

You may take about 4 to 6 weeks to fully recover. It's important to avoid lifting while you are recovering so that you can heal.

How many days rest after laparoscopy? ›

If you've had laparoscopy to diagnose a condition, you'll probably be able to resume your normal activities within 5 days.

Is ovulation painful after laparoscopy? ›

It is not uncommon, therefore, for the first ovulation and period after surgery to be quite painful, in some cases significantly so. Also, the first period after surgery is often heavy, cramp, clotty, and long.

Why am I not ovulating after laparoscopy? ›

Surgery in the uterus tissue could alter your ovulation cycle a little bit as your body adjusts to the changes that have occurred. This makes imperative that you check and sense your ovulation cycle closely so that you are able to know about the best dates to conceive.

What are the symptoms of poor egg quality? ›

There aren't many obvious symptoms of low egg reserve, so our fertility experts ask you about:
  • Absent or late periods.
  • Shorter-than-average menstrual cycles.
  • Irregular periods with a heavy or light flow.
  • History of miscarriage.

Does AMH level increase after laparoscopy? ›

Conclusions: Serum AMH levels decline significantly after laparoscopic cystectomy of endometriomas but recovered at 12 months compared with the first 6 months with unilateral endometrioma.

Can hysteroscopy help you get pregnant? ›

In subfertile women with a uterine cavity abnormality, removal of these abnormalities using hysteroscopy may be recommended to help increase the odds of pregnancy.

How long does it take to get pregnant after polyp removal? ›

However, pregnancy after polyp removal may take some time. The doctor would recommend waiting for at least 1-2 menstrual cycles before trying again. This timeframe gives the endometrial lining time to heal and for the lab results to return. If all goes well, pregnancy should be possible.

Does polyp removal increase fertility? ›

Endometrial polyps have been found to be associated with infertility. There is at least one good study that revealed that removal of the polyp increases the chances of conceiving. The study found that when a polyp was removed, the pregnancy rate was 63%.

What time of month is best for hysteroscopy? ›

In premenopausal women with regular menstrual cycles, the optimal timing for diagnostic hysteroscopy is during the follicular phase of the menstrual cycle after menstruation. Pregnancy should be reasonably excluded before performing hysteroscopy.

Does hysteroscopy reset your cycle? ›

A hysteroscopy does not disrupt your menstrual cycle. If your gynecologist removed the polyp or fibroid that caused your heavy or painful periods, you should have a lighter and/or less painful period. However, you may have some minor bleeding, spotting, or irregular periods for the first month after your hysteroscopy.

Is hysteroscopy related to infertility? ›

Hysteroscopy is often used to evaluate and treat women with infertility, unusual uterine bleeding or recurrent miscarriage. Infertility physicians use diagnostic hysteroscopy to identify abnormal uterine structure, uterine fibroids, polyps and scarring.

Will a laparoscopy change my cycle? ›

Ans: Yes, it is not unusual to miss or have a delayed period after laparoscopy.

What is the best fertility drug to get pregnant? ›

  • Clomiphene citrate. Taken by mouth, this drug stimulates ovulation by causing the pituitary gland to release more follicle-stimulating hormone (FSH) and luteinizing hormone (LH), which stimulate the growth of an ovarian follicle containing an egg. ...
  • Gonadotropins. ...
  • Metformin. ...
  • Letrozole. ...
  • Bromocriptine.

Can I conceive 2 months after laparoscopy? ›

The median time until pregnancy after laparoscopic intervention was 8 months (the average was 10 months).

What are the disadvantages of laparoscopy for infertility? ›

Laparoscopic surgery is generally safe, but it does come with risks that could affect fertility in the future. The procedure may cause injury or scarring to your fallopian tubes, uterus, or ovaries. These injuries could affect your ability to get pregnant.

What is not normal after laparoscopy? ›

When should I contact my doctor after laparoscopy? Contact your healthcare provider immediately if you experience any of the following: Persistent nausea and vomiting for more than 24 hours. Temperature over 100 degrees Fahrenheit for more than 24 hours.

Do I need to shave before laparoscopy? ›

Do not shave or wax any area on your body for a week before surgery (legs, bikini, underarms, etc.). Shaving can nick the skin and increase the risk of wound infection. If hair needs to be removed, it will be done at the hospital. 2.

What is the hardest part of IVF cycle? ›

The 10-14 day waiting period between transfer and receiving the pregnancy test results is often described as the most difficult part of the cycle. Having had daily contact with your medical support staff during monitoring and retrieval, you suddenly are on your own after transfer and just have to wait.

Which cycle day is best for laparoscopy? ›

Laparoscopy allows us to see the abdominal organs and sometimes make repairs, without making a larger incision that can require a longer recovery time and hospital stay. When Is Laparoscopy Done? Laparoscopy is done after your periods within 12 days from day-1 of your period.

Can laparoscopy open blocked tubes? ›

If your fallopian tubes are blocked by small amounts of scar tissue or adhesions, your doctor can use laparoscopic surgery to remove the blockage and open the tubes. If your fallopian tubes are blocked by large amounts of scar tissue or adhesions, treatment to remove the blockages may not be possible.

What is the best time for laparoscopy? ›

Laparoscopy is usually scheduled several weeks ahead of time and performed in the first 7-10 days after the end of a menstrual period. A physical and pelvic examination is done in the doctor's office 1-2 days before the surgery.

Does hysteroscopy increase IVF success? ›

Hysteroscopy has also been used to improve the chances of pregnancy in succeeding IVF cycles for women who have had one or numerous missed IVF cycles. For those that have a normal hysterosalpingogram before their IVF cycle, this allows for the diagnosis and treatment of intrauterine pathology.

Can laparoscopy damage ovaries? ›

Conclusion. The risk of removal of ovarian tissue during laparoscopic surgery is significantly higher for endometriomas than for dermoid cysts.

Can laparoscopy fail? ›

After a laparoscopy, serious problems are very uncommon. But they can include bleeding, infection, blood clots, damage to an organ or blood vessel, and problems from the medicine that made you sleep during the procedure.

Which is better hysteroscopy or laparoscopy? ›

Laparoscopy is performed to view and access the exterior of the uterus, ovaries, fallopian tubes and other structures within the pelvis. Hysteroscopy is performed to view the internal cavity of the uterus, identify abnormalities and perform certain corrective procedures.

How long is bed rest after laparoscopic hysterectomy? ›

Depending on various procedures, the individual may be advised to rest from two to six weeks, with the first two weeks consisting of bed rest. Patients will need good bed rest after a hysterectomy.

What is the best recovery after laparoscopy? ›

Most patients are able to resume normal activities within a few days to one week. Don't engage in any strenuous physical activity for about a week or so. Remove your bandages the following day. Keep wounds dry.

How do you sleep after a laparoscopy? ›

Sleeping in a semi-upright position is recommended, using a few pillows to elevate the head and shoulders to avoid putting pressure on the abdominal area. Avoid sleeping on your stomach or the side where the incisions were made.

Can I drive 4 days after laparoscopy? ›

Depending on the type of procedure performed, most patients can return to their normal activities within 1-2 weeks after their laparoscopy. Typically patients may return to driving 1-2 weeks after their procedure.

Do you stay overnight for a laparoscopy? ›

You can often go home on the same day of your laparoscopy, although you may need to stay in hospital overnight.

Are you more fertile after laparoscopy? ›

Will a laparoscopy hurt my chances of getting pregnant? For some women, who have undergone a laparoscopy to remove fibroids or endometriotic lesions, repair a hydrosalpinx, unblock a fallopian tube, or reverse a tubal ligation, the surgery actually increases the chances of getting pregnant.

How much does laparoscopy increase fertility? ›

Helping with Conception

Laparoscopy to remove dilated fallopian tubes (hydrosalpinges) has also been shown to improve IVF outcomes by 50 percent, and is highly recommended.

Are periods worse after laparoscopy? ›

Experiences with the first period after a laparoscopy can vary dramatically. If your period is more painful, longer, or heavier than usual, don't panic. Internal healing takes much longer than external healing. Therefore, your first few periods may be more painful.

Is ovulation delayed after laparoscopy? ›

Surgery in the uterus tissue could alter your ovulation cycle a little bit as your body adjusts to the changes that have occurred. This makes imperative that you check and sense your ovulation cycle closely so that you are able to know about the best dates to conceive.

Can laparoscopy affect early pregnancy? ›

Laparoscopic surgery is safe in any trimester of pregnancy. If possible, the second trimester is the best time to perform it. After the first trimester of pregnancy, patients should be positioned in left lateral or partial decubitus to minimize aortocaval compression.

Is laparoscopy related to infertility? ›

Laparoscopy for infertility is generally only performed after other fertility tests have not resulted in a conclusive diagnosis. For this reason, laparoscopy is often performed on women with unexplained infertility. Laparoscopy also allows for biopsy of suspect growths and cysts that may be hampering fertility.

How long after hysteroscopy can I try to conceive? ›

Time Between Hysteroscopy & IVF

After a hysteroscopy your doctor may recommend that you wait a few weeks or up to three months (for large fibroids) before starting an IVF cycle.

How do I know if I have poor egg quality? ›

There's no test for egg quality. The only way to know if an egg is chromosomally normal is to attempt to fertilize it, and, if fertilization is successful, to perform a genetic test on the embryo.

What is the best age to get pregnant with endometriosis? ›

When choosing the best time for pregnancy, considerations might include peak fertility, lifestyle, financial circumstances, and the cost of fertility treatments. Because fertility declines with age, most experts recommend trying to conceive before 35.

Does a laparoscopy change your cycle? ›

Ques: Can my first period be delayed after laparoscopy? Ans: Yes, it is not unusual to miss or have a delayed period after laparoscopy. It can happen due to both, physical and psychological stress.

What are the odds of miscarriage after a laparoscopy? ›

Laparoscopy was associated with a higher rate of fetal loss (7%) compared with open appendicectomy (3%) (Odds ratio (OR)=2.31, CI=1.51-3.55, p<0.5) but early delivery was less common in laparoscopic appendicectomy (<1%) compared to open (8%) (p<0.5).

Do you have to take a pregnancy test before laparoscopy? ›

Many surgeons recommend routine pregnancy tests for all patients prior to elective surgery because both surgery and anesthesia should be avoided during pregnancy.


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