Hysteroscopy for Infertility

Doctors commonly perform hysteroscopy to investigate and address issues in women who are facing difficulties with getting pregnant, dealing with abnormal uterine bleeding, or experiencing repeated miscarriages. They use diagnostic hysteroscopy to detect problems like irregular uterine shape, uterine fibroids, polyps, and scarring.

What is a hysteroscopy?

A hysteroscopy involves using a small tube with a light and camera to examine your cervix and uterus, and it is a safe procedure. The camera goes in through your vagina and up into the uterus. Fertility doctors use hysteroscopy to do the following:

  • Find out if there’s a problem in your uterus.
  • Take a tiny piece of tissue for testing (biopsy).
  • Get rid of uterine fibroids, polyps, or scar tissue in your uterus.
  • Do other treatments on your uterus or cervix when needed.

Two main types of hysteroscopy procedures are commonly done: Diagnostic and Operative hysteroscopy.

The diagnostic one helps doctors see the inside of the uterus and identify common issues like fibroids, uterine polyps, or uterine septum.

Operative hysteroscopy, on the other hand, is typically performed in the operating room with general anesthesia. It’s for patients who already have known problems inside their uterus, such as previously detected fibroids causing bleeding and fertility issues, uterine polyps, uterine septum, blocked Fallopian tubes, and more.

Why might you need a hysteroscopy?

  • You might require this procedure for the following reasons:
  • Your Pap test results indicate something unusual.
  • You have been experiencing postmenopausal bleeding.
  • There are fibroids, polyps, or scars in your uterus.
  • You’ve had multiple miscarriages or difficulties getting pregnant.
  • Your doctor needs to obtain a small piece of tissue from the lining of your uterus (biopsy).

Scar tissue forming inside the uterus or cervix typically causes Asherman syndrome, often after uterine surgery or dilation and curettage. Less common causes include tuberculosis and schistosomiasis. Hysteroscopy, providing a detailed view of the uterus, is used for both diagnosing and treating Asherman’s syndrome.

Procedure of hysteroscopy

A hysteroscopy can be done in a hospital or at your doctor’s clinic. You might be awake or asleep during the procedure. If you’re awake, your doctor will provide medication to help you relax and use tools called dilators to open your cervix.

Your doctor will probably use a tool called a speculum to keep your vagina open, so it’s quite similar to what they use for a Pap smear.

Then, they’ll gently put the hysteroscope through your cervix into your uterus and send gas or a liquid (like saline) into your uterus through the hysteroscope to make it bigger. This helps them see the lining of your uterus and the openings of your fallopian tubes more clearly.

After the Procedure

You can likely leave shortly after the procedure; however, if you have received local or general anesthesia, you’ll need someone to drive you home.

In the days following the procedure, you might experience slight cramps, bleeding, and some temporary gas, usually lasting about 24 hours. Your doctor may provide you with medication to manage any discomfort.

After the procedure, it’s essential to abstain from sexual activity for at least 2 weeks. Your doctor will give you instructions on how to care for yourself post-surgery before you head home.

Does a Hysteroscopy Hurt?

During the procedure, you’ll receive intravenous (IV) medication for moderate sedation or anesthesia, ensuring you won’t feel cramps or pinching.

How Long Does a Hysteroscopy Take?

In an examination room with mild sedation, a hysteroscopy typically lasts about 20 to 30 minutes. However, if performed in an operating room under anesthesia, the procedure can take up to two hours or longer, depending on the specific procedures required.


The primary reason for using hysteroscopy in infertility cases is when the uterine X-ray (hysterogram) appears unusual or unclear. Moreover, when combined with hysterosalpingography, it not only provides a more precise assessment of the uterus and endocervical canal but also helps identify issues that could impact fertility. Prepare for your hysteroscopy by discussing procedure details, duration, and recovery with your surgeon.


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