American Society for Reproductive Medicine

View all recommendations from this society

Released December 3, 2013

Don’t perform routine diagnostic laparoscopy for the evaluation of unexplained infertility.

In patients undergoing evaluation for infertility, routine diagnostic laparoscopy should not be performed unless there is a suspicion of pelvic pathology based on clinical history, an abnormal pelvic exam or abnormalities identified with less invasive testing. In patients with a normal hysterosalpingogram or the presence of a unilaterally patent tube, diagnostic laparoscopy typically will not change the initial recommendation for treatment.


These items are provided solely for informational purposes and are not intended as a substitute for consultation with a medical professional. Patients with any specific questions about the items on this list or their individual situation should consult their physician.

How The List Was Created

The Practice Committee of the American Society for Reproductive Medicine (ASRM) reviewed evidence from ASRM’s practice documents to identify possible topics along with suggestions for possible topics from the ASRM Board of Directors. By consensus, the Practice Committee narrowed the list to the top five most overused tests within specified parameters. Additional input was sought from the ASRM Board of Directors and incorporated. The final list was reviewed and approved by the ASRM Board of Directors. The ASRM Board of Directors and Practice Committee are comprised of representatives from every aspect of reproductive medicine through our five affiliated societies including the Society for Assisted Reproductive Technology, the Society of Reproductive Surgeons, the Society for Reproductive Endocrinology and Infertility, the Society for Male Reproduction and Urology and the Society of Reproductive Biologists and Technologists.

ASRM’s disclosure and conflict of interest policy can be found at www.asrm.org.

Sources

Pavone ME, Hirshfeld-Cytron JE, Kazer RR. The progressive simplification of the infertility evaluation. Obstet Gynecol Surv. 2011 Jan;66(1):31–41.

Lavy Y, Lev-Sagie A, Holtzer H, Revel A, Hurwitz A. Should laparoscopy be a mandatory component of the infertility evaluation in infertile women with normal hysterosalpingogram or suspected unilateral distal tubal pathology? Eur J Obstet Gynecol Reprod Biol. 2004 May 10;114(1):64–8.

Badawy A, Khiary M, Ragab A, Hassan M, Sherif L. Laparoscopy – or not – for management of unexplained infertility. J Obstet Gynaecol. 2010;30(7):712–5.

Bosteels J, Van Herendael B, Weyers S, D’Hooghe T. The position of diagnostic laparoscopy in current fertility practice. Hum Reprod Update. 2007 Sep-Oct;13(5):477–85.