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Hysteroscopy is a minimally invasive surgical technique that allows evaluation of the uterine cavity. This is important because abnormalities of the uterine cavity may prevent fertility and can even interfere with pregnancy.

Reasons for Hysteroscopy

Hysteroscopy allows doctors to directly view the cervical canal and internal uterine structure, potentially revealing defects that could lead to fertility problems including congenital abnormalities, polyps, scar tissue, tumors, or fibroids. Diagnostic hysteroscopy is performed when:

1. The results of a Hysterosalpingogram or Sonohysterogram show a uterine abnormality
2. Women have repeated miscarriages
3. A routine ultrasound shows evidence of a polyp or fibroid

Hysteroscopy Procedure

In preparation for hysteroscopy, the doctor may administer local or general anesthesia. To begin the hysteroscopy procedure the doctor will open the vagina with a speculum and cleanse the vaginal and cervix with a special antibacterial solution. The doctor will then insert a flexible hysteroscope through the cervical canal and distend the area with carbon dioxide gas or sterile saline to allow for better visualization of the uterine cavity.

After hysteroscopy, patients can expect minor discomfort and possible spotting, and will be able to resume normal activity within a few days. Patients should avoid sexual intercourse for at least one day after hysteroscopy.

Hysteroscopy and Fertility

Fertility-related diagnoses that can be made with hysteroscopy include:

Submucosal myomas
Uterine polyps
Adenomyosis (endometrium glands growing into the muscle wall of the uterus)
Scarring of the uterine lining (Asherman’s Syndrome)
Presence of a uterine septum or bicornuate formation
Congenital abnormalities of the uterus

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