Hysteroscopy

Hysteroscopy in IVF: A Complete Guide

With continuous advancements in medical science, several safe and minimally invasive techniques are now available that allow doctors to diagnose and treat reproductive conditions with minimal discomfort and risk. For women facing fertility challenges, procedures such as hysteroscopy play a vital role in evaluating the uterus without the need for large surgical incisions.

Hysteroscopy helps doctors examine the inside of a woman’s uterus and identify or treat conditions that may interfere with natural conception or assisted reproductive techniques like IVF.

What Is Hysteroscopy?

Hysteroscopy is a minimally invasive medical procedure that allows doctors to visually examine the inside of the uterus. It is commonly used to diagnose and treat conditions such as:

• Abnormal uterine bleeding
  
  

• Endometrial lining abnormalities
  
  

• Uterine fibroids
  
  

• Uterine polyps
  
  

• Adhesions (scar tissue)
  
  

• Congenital uterine abnormalities
  
  

The procedure is performed using a device called a hysteroscope, which is a thin, flexible tube equipped with a light source and camera. The hysteroscope is gently inserted through the vagina and cervix into the uterus. A sterile fluid or gas is used to expand the uterus, allowing the doctor to clearly view the uterine cavity and perform necessary treatments if required.

Types of Hysteroscopy

Hysteroscopy is broadly classified into two types:

1. Diagnostic Hysteroscopy

Diagnostic hysteroscopy is used to identify the cause of symptoms such as abnormal uterine bleeding, infertility, or repeated IVF failures. It may also be performed alongside other investigations like ultrasound or hysterosalpingography (HSG) to confirm a diagnosis.

Conditions commonly diagnosed include:

• Abnormal uterine bleeding
  
  

• Uterine fibroids
  
  

• Uterine polyps
  
  

• Intrauterine adhesions
  
  

• Endometrial cancer
  
  

2. Operative Hysteroscopy

Operative hysteroscopy is performed to treat abnormalities detected during diagnostic hysteroscopy. Minor surgical procedures can be carried out during the same session using specialized instruments passed through the hysteroscope.

Procedures performed include:

• Hysteroscopic polypectomy
  
  

• Myomectomy (fibroid removal)
  
  

• Endometrial ablation
  
  

• Septoplasty
  
  

• Adhesiolysis
  
  

Why Is Hysteroscopy Done?

Hysteroscopy is recommended for several diagnostic and therapeutic purposes, including:

• Diagnosis of uterine abnormalities
  
  

• Treatment of uterine conditions
  
  

• Evaluation of infertility
  
  

• Management of abnormal uterine bleeding
  
  

• Diagnosis of endometrial cancer
  
  

• Performing procedures such as polypectomy or septoplasty
  
  

Preparing for a Hysteroscopy

Hysteroscopy is usually an outpatient procedure, meaning the patient can return home the same day.

Before scheduling the procedure, the doctor will perform a physical examination and review symptoms. Hysteroscopy is generally not recommended for pregnant women or those with active pelvic infections.

General Preparation Guidelines:

• Discuss any questions or concerns with your doctor
  
  

• Inform your doctor about all medications or supplements you are taking
  
  

• Avoid sexual intercourse prior to the procedure to reduce infection risk
  
  

• Follow fasting instructions if advised
  
  

• Arrange transportation for the day of the procedure
  
  

• Wear comfortable clothing
  
  

What to Expect During a Hysteroscopy

The hysteroscopy procedure typically involves the following steps:

• You will be asked to empty your bladder and change into a hospital gown
  
  

• Anaesthesia or sedation may be given depending on the type of hysteroscopy
  
  

• You will lie on an examination table with your legs supported
  
  

• The doctor will perform a pelvic examination and gently dilate the cervix
  
  

• The hysteroscope is inserted through the vagina and cervix into the uterus
  
  

• A fluid solution is used to expand the uterus for clear visibility
  
  

• The uterine cavity and fallopian tube openings are examined
  
  

• Surgical instruments may be used to remove abnormalities if required
  
  

The procedure duration may range from 5 minutes to over an hour, depending on whether it is diagnostic or operative.

After a Hysteroscopy

After the procedure:

• You may be observed for a few hours if anaesthesia was used
  
  

• Most patients are discharged the same day
  
  

• Mild cramping, spotting, or light bleeding is common for a few days
  
  

• Sexual intercourse and tampon use should be avoided for at least a week
  
  

• Pain medication may be prescribed if needed
  
  

Contact your doctor immediately if you experience:

• Severe pain
  
  

• Fever
  
  

• Heavy bleeding
  
  

Your doctor will discuss the findings, results, and any further treatment or follow-up required.

Benefits of Hysteroscopy

Hysteroscopy offers several advantages, including:

• Minimally invasive diagnosis and treatment
  
  

• High precision during surgery
  
  

• Reduced risk of complications
  
  

• Less pain and trauma
  
  

• Faster recovery
  
  

• Shorter hospital stay
  
  

Hysteroscopy for IVF

Hysteroscopy plays an important role in optimizing IVF outcomes. For successful embryo implantation, the uterine cavity must be healthy and free from abnormalities.

Hysteroscopy before IVF helps to:

• Detect and remove polyps, fibroids, or adhesions that may interfere with implantation
  
  

• Assess the uterine lining for optimal embryo placement
  
  

• Improve overall IVF success rates
  
  

Possible Complications of Hysteroscopy

Although hysteroscopy is generally safe, potential complications may include:

• Fever
  
  

• Infection
  
  

• Heavy bleeding
  
  

• Fluid overload
  
  

• Intrauterine scarring
  
  

• Uterine perforation
  
  

• Reaction to anaesthesia or uterine distension fluid
  
  

• Injury to surrounding organs such as the cervix, bowel, or bladder
  
  

Any unusual or concerning symptoms should be reported to your doctor immediately. Choosing an experienced and qualified specialist significantly reduces the risk of complications.