Hi Dr, I am Brinda, 30yrs, F. Married since 7years. PCOD (on glycomet 850 and Normoz. Gone through 6 Follicular study no results. I conceived on own before 4years but it was miscarriage on 6th week (Only sac was seen could not see baby till 6th week scan). Now my Dr. Suggested for Advanced Diagnostic Hystereolaproscopy to find any blocks in my tubes and other fertile aspects. I would like to know if I surely have to undergo this laparoscopy or as an alternate could I go for IUI or IVF to conceive skipping this laparoscopy. Please advise. Thanks.

Dr. Parag PatilGynaecologist26yrs exp

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Its been 4 years since your last pregnancy which unfortunately had ended in a miscarriage. The medicines given to you must have resulted in ovulation, and the doctors must have adviced you to have sexual relations in the ovulatory period. But if this has not resulted in a pregnancy over 6 cycles, it means there is a need to evaluate your fallopian tube patency. Patency of the fallopian tubes is done by many methods: 1. Hsg - hysterosalpingography, which is an x ray taken when a dye is injected in your uterus 2. Sonosalpingography, where saline introduced in uterine cavity is seen on sonography to assess fallopian tubal patency 3. Hysterolaparoscopy. Here hysteroscopy will evaluate uterus and its lining, and laparoscopy will be used to assess the peritoneum, ovaries, fallopian tubal patency etc tubal patency will need to be established before taking up iui. So it is prudent to go for any of the tests mentioned above for tubal patency. If you want to go for ivf, tubal status need not be checked because in ivf we bypass the function of the tube i. E intratubal fertilisation (as this is made to happen -" invitro") 

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