What Is Hysteroscopy?

Hysteroscopy is a gynaecological procedure that allows a doctor to examine the inside of the uterus using a thin instrument called a hysteroscope. The instrument has a light and camera, helping the doctor view the uterine cavity and identify abnormalities that may require further evaluation or treatment.

Unlike procedures that examine the outside of the uterus, hysteroscopy provides a direct view of the uterine cavity. Depending on the findings, it may be used for diagnosis, treatment or both.

Hysteroscopy is not required for every woman experiencing infertility. A fertility specialist may recommend it when symptoms, ultrasound findings, previous pregnancy outcomes or other investigations suggest a problem inside the uterus.

How Can Uterine Problems Affect Fertility?

The uterus plays an important role in pregnancy. After fertilisation, the developing embryo must reach the uterus and implant into the uterine lining. Certain abnormalities inside the uterine cavity may affect this process or increase the risk of pregnancy complications.

Some conditions that may be investigated using hysteroscopy include:

1. Endometrial Polyps

Endometrial polyps are growths that develop from the lining of the uterus. Some polyps cause abnormal bleeding, while others may be discovered during an investigation for infertility.

Depending on their size and location, polyps may affect the uterine cavity. A doctor may recommend hysteroscopy to examine a suspected polyp and determine whether removal is appropriate.

2. Submucosal Fibroids

Fibroids are non-cancerous growths that develop in or around the uterus. Submucosal fibroids extend into the uterine cavity and may affect its shape.

When a fibroid distorts the cavity, it may be associated with difficulties conceiving or certain pregnancy complications. In selected cases, hysteroscopy can help the doctor assess the fibroid and determine whether hysteroscopic removal is suitable.

3. Intrauterine Adhesions

Intrauterine adhesions are bands of scar tissue that form inside the uterus. They may develop after certain uterine procedures, pregnancy-related events or infections.

Adhesions can sometimes interfere with normal menstruation, the uterine cavity or reproductive outcomes. Hysteroscopy allows the doctor to identify adhesions and, when appropriate, consider treatment.

4. Abnormalities of the Uterine Cavity

Some structural abnormalities can affect the shape of the uterine cavity. Hysteroscopy may help investigate selected abnormalities, although ultrasound and other imaging tests may also be needed to assess the uterus fully.

The appropriate investigation depends on the suspected condition. Your doctor can explain which tests are most useful before recommending a procedure.

When Is Hysteroscopy Recommended During an Infertility Evaluation?

A fertility specialist may consider hysteroscopy when there is a specific reason to investigate the uterine cavity.

Situations may include:

• Ultrasound findings suggesting a polyp, fibroid or other uterine abnormality.
• Unexplained abnormal uterine bleeding.
• Suspected intrauterine adhesions.
• Repeated pregnancy loss when uterine evaluation is indicated.
• Selected cases of unsuccessful fertility treatment where further uterine assessment may be appropriate.
• Findings from other investigations that require a closer examination of the uterine cavity.

Hysteroscopy is not automatically recommended after every unsuccessful IVF cycle. Evidence of a possible uterine problem and the patient’s individual history help determine whether the procedure is likely to be useful.

For a broader overview of fertility investigations and treatment options, read Samad Hospital’s reproductive medicine guide.

Diagnostic Hysteroscopy vs Operative Hysteroscopy

There are two main approaches to hysteroscopy, depending on the purpose of the procedure.

Diagnostic Hysteroscopy

Diagnostic hysteroscopy is performed to examine the uterine cavity. The doctor looks for abnormalities such as polyps, adhesions or certain fibroids.

The procedure may be recommended when other tests have identified a possible issue that needs closer assessment. The setting, pain management and preparation depend on the patient’s circumstances and the clinical approach.

Operative Hysteroscopy

Operative hysteroscopy allows the doctor to treat certain abnormalities identified inside the uterus. Depending on the findings, instruments can be passed through the hysteroscope to remove selected polyps, treat suitable fibroids or divide adhesions.

Not every abnormality can be treated hysteroscopically. The size, position and type of the problem, along with the patient’s medical history, determine whether this approach is appropriate.

Learn more about laparoscopy and hysteroscopy surgery at Samad Hospital.

What Happens Before, During and After Hysteroscopy?

Understanding the process can help patients feel more prepared for the procedure.

Before the Procedure

Your doctor will review your symptoms, medical history, medications and previous investigations. Pregnancy should be excluded when appropriate, and the timing may be planned around your menstrual cycle.

Depending on the procedure and your clinical needs, the doctor may discuss pain relief, local anaesthesia, sedation or general anaesthesia.

Ask your healthcare team whether you need to avoid eating or drinking beforehand, especially if sedation or general anaesthesia is planned.

During the Procedure

A hysteroscope is gently passed through the vagina and cervix into the uterus. Fluid may be used to expand the uterine cavity so that the doctor can examine the lining.

The duration depends on whether the procedure is diagnostic or involves treatment. Some procedures can be performed in an outpatient setting, while others may require an operating theatre and anaesthesia.

Patients may experience cramping or discomfort. The degree of discomfort varies, so pain-management options should be discussed with the treating doctor.

After the Procedure

Recovery depends on the type of hysteroscopy and whether treatment was performed. Mild cramping and light vaginal bleeding or spotting may occur for a short period.

Follow the instructions provided by your healthcare team regarding medication, physical activity, intercourse and the timing of your next fertility treatment.

Seek urgent medical advice if you develop severe or worsening abdominal pain, heavy bleeding, fever, foul-smelling vaginal discharge or feel seriously unwell.

Can Hysteroscopy Improve IVF Success?

Hysteroscopy can help identify and treat certain abnormalities inside the uterus, which may be important when planning fertility treatment. However, it does not guarantee pregnancy or improve IVF outcomes for every patient.

If a polyp, adhesion or cavity-distorting fibroid is identified, treatment may be considered based on its location, size, symptoms and potential reproductive significance. The decision should balance the possible benefits of treatment against procedural risks and the time required for recovery.

For patients preparing for IVF, the fertility specialist will determine whether uterine assessment is needed before embryo transfer. You can also read about embryo transfer as part of IVF treatment.

The best approach is to investigate specific concerns rather than perform hysteroscopy routinely without a clear clinical reason.

Are There Any Risks Associated With Hysteroscopy?

Hysteroscopy is generally considered a commonly performed gynaecological procedure, but complications can occur. The risks depend on the type of procedure, the patient’s health and whether operative treatment is performed.

Potential complications include infection, bleeding, injury to the cervix or uterus, and complications related to anaesthesia. In some procedures, the fluid used to expand the uterus can also cause complications if absorbed in excessive amounts.

Your doctor should explain the risks relevant to your planned procedure, the expected recovery and any alternative investigations or treatments.

Hysteroscopy for Infertility at Samad Hospital

Difficulty conceiving can be emotionally challenging, particularly when investigations identify a possible uterine problem. Understanding the cause can help you and your doctor decide which steps may be appropriate.

Samad Hospital provides gynaecological and reproductive medicine care for patients who need assessment for fertility concerns. A consultation can help determine whether hysteroscopy or another investigation is suitable based on your symptoms, previous results and treatment history.

You can also explore Samad Hospital’s information about hysteroscopy and its cost to learn more about the procedure.

If you have been advised to undergo hysteroscopy, ask your doctor what the procedure is intended to investigate, whether treatment may be performed at the same time and how the findings could influence your fertility plan.

Conclusion

Hysteroscopy can be a useful diagnostic and treatment option when abnormalities inside the uterine cavity are suspected during an infertility evaluation. It allows a doctor to examine the uterine lining directly and, in selected cases, treat problems such as polyps, certain fibroids or adhesions.

However, not every woman experiencing infertility needs hysteroscopy, and the procedure cannot address every cause of difficulty conceiving. The decision should be based on clinical findings and individual reproductive goals.

A consultation with a gynaecologist or fertility specialist at Samad Hospital can help you understand your investigation options and plan the next steps towards pregnancy.

Frequently Asked Questions

1. Is hysteroscopy painful?

Some patients experience cramping or discomfort, while others tolerate the procedure well. The experience depends on the type of hysteroscopy and individual circumstances. Your doctor can explain the available pain-relief and anaesthesia options.

2. Can hysteroscopy help me get pregnant?

It may help when a uterine abnormality that affects reproductive health is identified and appropriately treated. However, it does not guarantee pregnancy, and other fertility factors may also need evaluation.

3. Is hysteroscopy necessary before IVF?

No. It is not required for every IVF patient. A fertility specialist may recommend it when symptoms, imaging findings or medical history suggest a need to examine the uterine cavity more closely.

4. How long does recovery take after hysteroscopy?

Recovery varies according to whether the procedure is diagnostic or operative. Some patients resume normal activities quickly, while others may need additional recovery time. Follow your doctor’s individual instructions.

5. Can hysteroscopy remove uterine polyps?

Yes, suitable endometrial polyps can often be removed during operative hysteroscopy. The doctor will determine whether removal is appropriate based on the polyp’s size, location and clinical significance.

6. When can I try to conceive after hysteroscopy?

The timing depends on the reason for the procedure, whether treatment was performed and how the uterus recovers. Your doctor will advise when it is appropriate to resume trying naturally or proceed with fertility treatment.