Fertiloscopy is performed as an ambulatory technique. There are five steps in this procedure: hydropelviscopy, dye test, salpingoscopy, microsalpingoscopy, and hysteroscopy. One of the prerequisite of operative fertiloscopy was to be as effective as the same procedure practiced during laparoscopy. Compared to laparoscopy, fertiloscopy has also some advantages like the facility to perform salpingoscopy and microsalpingoscopy. Fertiloscopy was first designed to avoid diagnostic laparoscopy. Operative possibilities were developed later. The complication rate is low, almost always avoidable if contraindications are strictly respected. Endometriosis may also be treated by operative fertiloscopy, when minimal or moderate. If the lesions are extensive or severe, then laparoscopy has to be the preferred option. Some techniques like fertiloscopic ovarian drilling in polycystic ovarian syndrome (PCOS) patients have already demonstrated its interest in the pregnancy rate obtained without the risks of ovarian hyperstimulation syndrome (OHSS).

Microlaparoscopy offers the advantage of carrying out many diagnostic and operative gynecologic procedures in a rapid, minimally invasive approach. Proper patient selection is very important for the success of the procedure. Microlaparoscopy could be performed either with general anesthesia or with local anesthesia under conscious sedation, which is a state of depressed consciousness allowing communication with the patient during the procedure. An umbilical incision is made (a local anesthetic block is done first in a case of conscious sedation) through which the interlocking trocar with the Verres needle is introduced to the abdomen. Most of the patients can leave the office within one hour of the procedure. Microlaparoscopy is currently used for infertility assessment, surgical management of endometriosis, lysis of pelvic adhesions, ovarian drilling, gamete intrafallopian transfer, tubal embryo transfer, hydrosalpinx removal before in vitro fertilization (IVF), and management of ectopic and heterotopic pregnancy.