Hysteroscopy may be discussed to examine or treat conditions affecting the uterus. The clinical recommendation depends on the patient’s symptoms and evaluation.
Hysteroscopy is a surgical procedure allowing doctors to view the inside of the uterus using a small, flexible tube with a camera (hysteroscope). It is used to diagnose and treat conditions that affect fertility, such as uterine fibroids, polyps,uterine infections and adhesions. It can treat uterine fibroids and polyps. It can also diagnose the cause of abnormal bleeding.
Routine hysteroscopy before a first IVF cycle is not recommended by current guidance. It may be considered when: an ultrasound or HSG suggests a polyp, fibroid, septum or adhesions; there is abnormal bleeding; there have been recurrent pregnancy losses or unsuccessful embryo transfers and a uterine cause is suspected; or a previous procedure or infection may have left scarring.
Some women are born with a differently shaped uterus. A septate uterus (a wall of tissue dividing the cavity) is the anomaly most often associated with pregnancy loss and can be treated by hysteroscopic septum resection; bicornuate, unicornuate and arcuate shapes are managed differently and often need no treatment. Diagnosis is by 3D ultrasound or MRI, sometimes with hysteroscopy and laparoscopy together.
Hysteroscopy is generally safe. Uncommon risks include infection, bleeding, perforation of the uterine wall, and problems related to the fluid used to expand the cavity or to anaesthesia. Risks are explained and consent taken before the procedure.
Dr. Spoorthy Chennamaneni, MBBS, DGO, MS (Obstetrics & Gynaecology), FRM (Fellowship in Reproductive Medicine), Telangana State Medical Council Reg. 070142, with 12+ years of experience, consults in English, Telugu and Hindi at Conceiva Fertility, Kondapur.