I am a 20-year-old student. When I was 16, I was diagnosed with chlamydia. I don't know how long I had it before then. Now I'm worried that I may have future trouble becoming pregnant. This worry is practically destroying my peace of mind. My gynecologist is not listening to my fears; he insists that I not be concerned with this right now. I have insurance coverage for now through my parents, so I'd like to find out while I can. Would a laparoscopy tell me if I have a problem, or is there another test? Do I have to have some sort of pending medical problem to get a test?

--Nicole

An hysterosalpingogram (HSG), an X-ray test of the fallopian tubes, can be used to determine if your fallopian tubes are open. However, this procedure can be painful and can cause infection and damage to your fallopian tubes. You may also have an allergic reaction to the dye used for the test. Therefore, I would not order this test in your situation.

A laparoscopy is an expensive surgical procedure used to diagnose and treat medical conditions. Again, there can be significant risk. As you do not have infertility, this test would not be appropriate, even if you have insurance coverage.

Still, while we can't say for sure that your tubes are normal, just having a chlamydia infection rarely results in significant damage to your tubes. Even if the chlamydia led to severe pelvic inflammatory disease (PID), marked by pain, fever, and a high white blood cell count, you are unlikely to have compromised your fertility. With one episode of PID, your chance of infertility is about 15 percent. So, for now, I do not believe that any evaluation is medically appropriate. I suggest that, instead, you consider counseling if you feel overwhelmed by your fears.