Infertility/Fertility/IVF necessary or not



Greetings from india. My name is Sapna, 31 years old. I have been trying for 3 years but with no avail. I had my 3D TVS scan and gynaecologist doctor told me that i maybe diagnosed with endometriosis. Then I was told to go for an IVF as nothing was working out with us for a baby. I was told to go for a HSG. I got it done and was informed that most probably my both tubes were blocked or mostly the dye didn't go in.

Then I consulted an infertility specialist and she told me to again go for a TVS scan. She also told me that the HSG scan was not done properly and to redo it. She also said that in order to come to a final conclusion for IVF, laparascopy was required.
I had the following query:

1. I wanted to know if the HSG scan is required or not for IVF?
2.If my fallopian tubes come out normal then is still laparascopy also required?
3. when IUI  be considered an option?

Kindly suggest if my treatment is proper or should i refer to another infertility specialist.

Awaiting for your revert with great hope.


Hello Sapna from India,

Laparoscopy is the only way that endometriosis can be diagnosed and would only be required if you wanted to continue to try using a natural method such as ovulation induction or IUI.  If you are going to do IVF, laparoscopy is not required.

HSG's usually do not need to be repeated, but it is an option if you don't want to do IVF.  That is because if the tubes are blocked, then IVF is required.  If the tubes are not blocked then you could consider a natural option like IUI.

In most cases, IVF is a last resort except in cases where a natural treatment method is not an option such as stage 3 or 4 endometriosis, blocked tubes or severe sperm abnormality.

Good Luck,

Dr. Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program

Monterey, California, U.S.A.

for additional information check out my blog at check me out on twitter with me at @montereybayivf and facebook @montereybayivf.  Skype and internet comprehensive consultations now available via my website for those who want a more extensive evaluation that this site can accommodate.  I also now provide an Email Concierge Advisory Service with a 1 year subscription for patients that want easy access to me to answer questions along their journey (women's health, infertility, pregnancy).  Contact me at if you are interested in continuous access to me.


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Edward Joseph Ramirez, MD, FACOG


I am a specialist in infertility and advanced gynecological care. I can answer questions about infertility, gynecology related ills, menopause...virtually anything that affects women's health. PLEASE tell me where you are writing from as I am always interested.


I have been practicing as an Ob/Gyn and Infertility Specialist for over 23 years. Gynecology, advanced laparoscopic surgery, basic infertility, IUI's, IVF, reproductive surgery, and ovulation induction are all areas of my expertise. I am Board Certified. I have been doing In Vitro Fertilization in my clinic for 19 years.

American College of OB/GYN, American Board of Obstetrics and Gynecology, American Society of Reproductive Medicine, California Medical Association, American Association of Gynecologic Laparoscopists, Fellow of The American College of Obstetricians & Gynecologists

American Journal of Obstetrics and Gynecology, Wall Street Journal, Monterey Herald, SERMO, Women's Health and Fertility Blog

Medical Degree from Stanford University, Residency at Tripler Army Medical Center, Reproductive Training at Pacific Fertility Center, San Francisco

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