A laparoscopy and dye test is an operation that has to be carried out under general anesthetic, although you can usually go home a few hours afterwards so it doesn't involve an overnight stay in hospital. During the test, the doctor uses a tiny telescope (laparoscope) to look at the condition of the womb and fallopian tubes.
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Once you are asleep, the doctor makes a small cut just beneath your navel, and your abdomen is inflated with carbon dioxide to give a clear view. Then the laparoscope is put through the incision, and dye is injected through the tubes to make sure they are clear, or 'patent'. If there are no blockages or scarring, the dye passes through the tubes freely and spills out the ends.
The laparoscopy does not usually cause any problems, although you will probably feel some discomfort around the cut, and you may feel bloated or have a stomach ache. There ia also sometimes pain around the shoulder, which is caused by the left-over gas in the abdomen. Some women, particularly those who have never had a general anaesthetic before, find the prospect of an operation rather alarming, but a laparoscopy is a fairly standard fertility investigation. It is often suggested when there is suspected endometriosis or a history of pelvic inflammatory disease, and can give a more detailed assessment of any blockages or adhesions that have shown up on an HSG or HyCoSy.
'I've had quite a few laparoscopies and they aren't too bad. The recovery time can be up to a week and I did have shoulder pain, but it really didn't feel too bad. There's nothing to worry about. I had my appendix out this year, and that was much worse.' Gillian, 34
Hysteroscopy
A hysteroscopy is an examination of the womb that involves putting a small telescope (hysteroscope) through the cervix. It may be carried out when you are having a laparoscopy, or can be done separately. You will be given a local anaesthetic or some form of sedation before the hysteroscopy is carried out. The hysteroscopy gives a good view of the inside of the womb, but is usually offered only where there is a reason to suspect there may be problems. Fibroids, adhesions or any irregularities in the shape of the womb can be assessed with a hysteroscopy.
Reproductive immunology
Still fairly new, reproductive immunology is a rather controversial area of fertility testing and treatment. It is based around the idea that the female immune system may react against sperm and embryos, stopping fertilisation and implantation or causing miscarriage.
It may be suggested that you should have tests to check whether your immune system could be preventing you getting pregnant or maintaining a pregnancy. Usually this will mean having blood tests, but you may be offered other tests, such as an endometrial biopsy where a small piece of the womb lining is taken out for further testing, and you may then be offered treatment. The test results may suggest that you have raised antibodies, or higher than normal levels of the natural killer (NK) cells that we all carry in our bodies.
There are only a few clinics offering these tests, as many doctors consider them to be of limited value. They say, for example, that testing levels of NK cells in the blood is of little use as they are totally different to the NK cells that are found in the womb. If you've had recurrent miscarriages, or a number of unsuccessful IVF attempts, you may consider investigating this area, but it is important to remember that these tests and treatments are still in their infancy and are not scientifically proven. To find out more, you can check out Women Infertility Causes.
