Hysteroscopy involves visual examination of the inside of the uterus to diagnose and/or treat problems of the womb (uterus). A hysteroscope is a medical instrument used for hysteroscopy procedures. It consists of a thin, lighted tube with a camera at the end. It plays a crucial role in fertility evaluation and treatment.

How is Hysteroscopy performed?

Brief overview of the typical procedure of hysteroscopy:

  • Preparation: The patient is given medication to help relax the uterus; local or general anaesthesia might be used depending on the extent of the procedure.
  • Positioning: The patient is usually positioned on her back, with legs in stirrups.
  • Insertion of hysteroscope: The hysteroscope is then carefully inserted through the cervix into the uterus. The procedure can be done using either a rigid or flexible hysteroscope.
  • Visual examination: The hysteroscope allows the doctor to view the uterine lining and the openings to the fallopian tubes; images may be captured for documentation.
  • Treatment procedures and biopsy: If abnormalities are detected, the doctor may perform minor surgical procedures like removing polyps, fibroids, or taking a tissue biopsy. This can help diagnose and treat various conditions.
  • Conclusion: Once the procedure is complete, the hysteroscope is removed, and the patient is monitored for a short period.
  • Recovery: Recovery time is typically short, and patients may experience mild cramping or discomfort. Most can resume normal activities within a day.

When is hysteroscopy used?

Hysteroscopy is used for diagnosing and treating various uterine issues. Common uses include:
Diagnosis of Abnormal Uterine Bleeding: Hysteroscopy helps in investigating the cause of irregular or heavy menstrual bleeding.

  • Treatment of uterine abnormalities: If abnormalities are detected during hysteroscopy, this can be often treated immediately. For example, polyps or fibroids can be removed, improving the chances of successful implantation and pregnancy.
  • Investigating recurrent pregnancy loss: Recurrent miscarriages may be linked to uterine abnormalities. Hysteroscopy helps in identifying and addressing such issues, potentially the chances of a successful pregnancy.
  • Diagnosing and treating Uterine Adhesions: Intrauterine adhesions, also known as Asherman’s syndrome, can result from previous uterine surgeries or infections. Hysteroscopy allows the diagnosis and treatment of these adhesions, restoring the normal uterine environment for infertility.
  • Evaluation of Tubal openings: Hysteroscopy allows visualization of the openings of the fallopian tubes into the uterus. This is crucial for assessing tubal patency, which is vital for natural conception.
  • Assessment of uterine shape and size: Uterine abnormalities like a bicornuate or septate uterus can impact fertility. Hysteroscopy provides a detailed view of the uterine anatomy, helps in understanding potential challenges and guiding appropriate interventions.  
  • Endometrial Ablation: A procedure to treat abnormal bleeding by removing or destroying the uterine lining.
  • Biopsy: Collecting tissue samples for further examination if there are concerns about abnormalities. 

In summary, hysteroscopy serves a pivotal role in the assessment and treatment of infertility. It enables the identification and immediate resolution of structural abnormalities by providing  direct visualization of the uterine cavity . Its utility to offer both diagnostic insights and on-the-spot treatment makes it an integral component of infertility evaluation, contributing to improved reproductive outcomes for individuals facing infertility challenges.