Laparoscopy and hysteroscopy are one of the most overused, misused, and abused procedures today for infertile patients. It’s widespread to see that a lot of doctors will still do these - both before doing an IVF cycle, and afterward as well. And it's very easy for them to justify doing these invasive procedures because patients don't know enough to ask intelligent questions. Many reassure the patient by saying it’s a “ simple “ diagnostic procedure that just takes a few hours, needs only a small cut, and doesn’t require overnight hospitalization. They minimize the fact that it is a surgical procedure and that the only “minor surgery” is one done on someone else! More importantly, they fail to tell the patient why they need to do the surgery. The airy, superficial explanation they provide is – we need to get more information and we need to see what's happening inside. It will allow us to find endometriosis or adhesions, which we won't be able to do otherwise. But this is just a pretext they use because the reality is that IVF patients do not require either a laparoscopy or a hysteroscopy because this doesn't actually change any of the treatment options we offer during the IVF cycle itself.

The truth is that this surgery is an additional source of revenue for the IVF doctor - or for the gynecologist who refers the patient for IVF! Many are happy to do the surgery and justify this by saying they are “preparing “ the patient for IVF.

The one question which you need to ask to protect yourself from unnecessary surgery is simple – How will this change the IVF treatment I will be doing? Now, smart doctors also have an answer for this and say – You may have a hydrosalpinx, and we need to clip it, which is why you need a laparoscopy. Or you may have endometriosis, and by “treating” it by burning It before IVF, we can improve IVF success rates. They also justify the hysteroscopy by saying it allows them to look inside the cavity and confirm it is normal. The fact of the matter is that if the uterine cavity is normal on a vaginal ultrasound scan, then there is really no point in doing an invasive hysteroscopy, no matter how minor the procedure may be, because it's going to turn out to be normal. It doesn't add any value to the patient at all. But the problem is that doctors will do it routinely because it’s part of their “clinic protocol”. And when they find that everything is normal during the surgery, they justify the surgical intervention by doing additional unnecessary surgical procedures, such as a metroplasty or an endometrial scratch, to vindicate themselves. This also helps them to pad their bills and ask for additional money from the patient because they “treated” the abnormality. It’s sad that patients continue being taken for a ride because you need to remember that the best surgery is the one that doesn't need to be done.