### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Hi, I am 34 yrs old and trying to conceive for 3 yrs now but with no luck. I have undergone all tests before proceeding to IUI treatment and all seems fine with me and hubby. I have regular periods and both tubes are open. I have done IUI 3 times but not successful. The doctor told me to undergo laparoscopic operation this time to investigate further but I am so scared to undergo this laparoscopy operation. Doctor here also said that after laparoscopy operation and everything is fine, i must go back to IUI again but with FSH drugs for 3 cycle and if its not going to work, will proceed to IVF . What s wrong with me? and I don t understand why to go for laparoscopy or back to IUI when it already didn t work for 3 times. and why not directly go to IVF procedure? Is laparoscopy operation really necessary? I am very afraid to take the risks of this kind of operation

### output:

Hi Welcome to Chat Doctor As per your history you are suffering from unexplained infertility. As you are already 34 yrs (with increasing age and time to conception fertility further reduces) and have been trying for 3 yrs, you need to be thoroughly evaluated by doing a laparoscopy+ hysteroscopy. Why Laparoscopy?? Sometimes few patients may have minimal endometriosis or mild adhesions which may affect the function of tubes and leads to infertility. By doing laparoscopy adverse factors if any can be ruled out or treated. Also tubes can be evaluated under direct vision Hysteroscopy is the procedure where inside uterine cavity is viewed using a camera and if any pathology found can be treated at the same time. Laparoscopy is a day care procedure where you can go same day or next day morning. Don't get scared. As your doctor already said you can try GUI after laparoscopy because immediately after surgery there is good chance of conception. If 3 Luis fail after laparoscopy you can go ahead with IVF. IVF can be done directly, but you need to undergo hysteroscopy before IVF for the reasons explained above. Trust your doctor.  All the best