If you have been trying to conceive without success, one of the questions we need to answer is whether your fallopian tubes are open. The tubes carry the egg from the ovary towards the womb, and are where the egg and sperm meet — if they are blocked or damaged, conception becomes difficult or impossible.

A laparoscopy and dye test is one way to check this, and it can treat some problems at the same time.

When we offer it

Laparoscopy is not usually the first thing we do. In both of the common situations, we start with medical treatment and move to laparoscopy if that does not work:

  • If you have pelvic pain — we offer medical treatment first, and consider laparoscopy if the pain does not settle.
  • If you are being seen for fertility — we again begin with medical treatment, and offer laparoscopy if it fails.

This ordering matters because laparoscopy involves a general anaesthetic and surgery, so it makes sense to try simpler measures first. Where there is a clear reason to look sooner — a strong suspicion of tubal damage or endometriosis, for example — your doctor may recommend going ahead earlier.

What causes blocked tubes

  • Previous pelvic infection (pelvic inflammatory disease)
  • Endometriosis
  • A previous ectopic pregnancy
  • Previous abdominal or pelvic surgery, and the adhesions that can follow
  • Occasionally, a tube that formed differently before birth

What the test involves

The procedure is done under general anaesthesia and usually takes under an hour.

The surgeon makes a small incision near your navel and passes a laparoscope — a thin telescope with a camera — into the abdomen, which is gently inflated with carbon dioxide to give a clear view. A coloured dye is then passed into the womb through the cervix. If the dye flows through the tubes and spills out at their ends, the tubes are open. If it does not, there is a blockage.

Because the surgeon can see your pelvis directly, the same operation also shows up endometriosis, adhesions, fibroids and ovarian cysts — and many of these can be treated there and then.

The day itself, and afterwards

You will be asked not to eat or drink for several hours beforehand. Most women go home the same day or after one night. Expect some abdominal soreness, and shoulder-tip discomfort for a day or two — this is from the gas used during the operation and passes on its own. Simple painkillers are usually enough. Most women feel back to normal within a few days to a week.

Your surgeon will explain the findings afterwards, including anything that was treated during the operation.

Risks

Laparoscopy is generally safe, but as with any operation there are risks: bleeding, infection, injury to the bladder, bowel or blood vessels, and risks associated with general anaesthesia. Serious complications are uncommon. Your surgeon will discuss them with you before you consent.

How it compares with the other tests

Two less invasive tests can also assess the tubes:

  • HSG (hysterosalpingogram) — an X-ray with contrast dye. No anaesthetic needed, but it does involve a small dose of radiation and shows only the inside of the tubes.
  • HyCoSy — an ultrasound-based version, with no radiation.

Both are reasonable first tests and are appropriate for many women. Laparoscopy’s advantages are that the surgeon sees the pelvis directly, can identify conditions the other tests would miss, and can treat problems during the same procedure. Its disadvantages are that it needs a general anaesthetic and carries surgical risk. Which is right for you depends on your history and what we are looking for.

The bottom line

A laparoscopy and dye test tells us reliably whether your tubes are open, and lets us treat problems such as endometriosis and adhesions at the same time. We generally try medical treatment first and turn to laparoscopy if that does not work. If you are struggling to conceive, come and talk to us about which investigations make sense in your situation — you may also find our guide to ovulation induction useful.

References

  1. National Institute for Health and Care Excellence. Fertility problems: assessment and treatment. NG257. London: NICE; 2026. Available from: https://www.nice.org.uk/guidance/ng257
  2. National Health Service. Infertility [Internet]. NHS; [cited 2026 Jul 22]. Available from: https://www.nhs.uk/conditions/infertility/
  3. National Health Service. Laparoscopy (keyhole surgery) [Internet]. NHS; [cited 2026 Jul 22]. Available from: https://www.nhs.uk/conditions/laparoscopy/