In the Laparoscopic tubal patency test, a little incision is made at the lower border of the umbilicus. The abdominal cavity will be distended with carbon dioxide gas to create extra space to accurately view the pelvic organs. A slim telescope called a laparoscope is then inserted into the abdominal cavity and also the uterus, tubes, and ovaries are thoroughly inspected. The presence of adhesions either around the tubes or tethering the ovaries can be easily detected, as well as their significance assessed. Other pelvic problems for example endometriosis and fibroids will also be revealed. Tubal patency is tested by injecting methylene blue dye into the uterus through the cervix. When the tubes are healthy, the dye can be seen passing along them and escaping through the outer openings of the tubes. The great advantage of laparoscopy over H.S.G. is it allows the surgeon to have a direct view of the pelvic organs and thereby permits a much more accurate assessment of tubal patency and then any tubal or ovarian problems. The need for further surgery can be determined without having to resort to major abdominal surgery in those days. The majority of patients can leave the hospital the following day. The tiny operation scar is eventually virtually invisible.