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Houston Fertility Journal

    Hysteroscopy for Infertility: Why, When, and How

    January 25, 2019 / by Center of Reproductive Medicine   

    Center of Reproductive Medicine


    If you are seeking out information about hysteroscopy, most likely you or someone you know has been told that they should have the procedure. A doctor usually discovers the need for this surgery when their patient has experienced the usual symptoms or if they have been having trouble getting pregnant.

    Hysteroscopy helps the doctor to look into the uterus in order to diagnose and treat any existing issues. A hysteroscope, a small telescope with a light connected to it, is inserted through the vagina and into the uterus. A camera on the hysteroscope provides images that the doctor will view on a screen so that they are able to see exactly what is causing their patient trouble. If your doctor has recommended this for you, there is nothing to be afraid of.

    The procedure will hopefully give you the answers that you are searching for. Keep reading to learn the why, when, and how of this procedure and what it could mean for you.

    Why Hysteroscopy is Performed


    The common reasons that hysteroscopy is performed are:

    • To find the cause of abnormal bleeding, which usually means that a woman’s menstrual periods are heavier or last longer than usual.
    • To remove adhesions that could have been the result of an infection or past surgery.
    • To find the cause of multiple miscarriages when a woman has more than two in a row.
    • To place small implants into the woman’s fallopian tubes as a permanent form of birth control called sterilization.
    • To find and remove an intrauterine device.
    • To diagnose existing conditions, such as fibroids and polyps (non-cancerous growths within the womb).
    • To remove such fibroids and polyps.

    Before hysteroscopies were performed, the doctor would perform a procedure called dilatation and curettage (D&C) in order to examine the womb and abnormal growths. Hysteroscopies provide a much clearer view into the women’s reproductive organs and allow doctors to be more accurate with their diagnosis’ and surgeries.

    When will the Procedure Occur?

    Once your doctor has recommended that you undergo a hysteroscopy, it is up to you whether or not you want to go forward with it. If you trust your doctor, all that you need to do now is make the appointment for a time that works for you. When you schedule this appointment, plan to give yourself a day to rest and get back to feeling normal. This is not always the case, but you may have some slight cramps or vaginal bleeding following the procedure. It’s best to plan for this and make sure to give yourself the rest that your body deserves.

    If you wish to ask another doctor if they think that hysteroscopy is necessary, there is nothing wrong with that. It is very common to ask for a second opinion when you are not sure, and it is not an insult to your physician. You will definitely want to get a second opinion if:

    • You have undergone treatment and your symptoms continue.
    • You are diagnosed with a rare disease.
    • You are diagnosed with cancer.
    • Your instincts tell you that something is not right.

    How to Prepare and what to Expect

    If you and the doctor decide on general anesthesia in the hospital, you will be told not to eat or drink anything before the procedure (usually starting from the night before). You may also undergo some routine lab tests that are common for women who undergo hysteroscopies within a hospital.

    In this case, you will be asked to empty your bladder and clean your vaginal area with an antiseptic. Once you are properly dressed and in the room that the procedure will be performed, you will be prepared for anesthesia:


    Local anesthesia: An injection of anesthetic will be given to you around the cervix area to ensure that it is numb. You will remain awake with this type of anesthesia and possibly experience some mild cramping.

    Regional anesthesia: An injection will be given to you in your lower back, this will block the nerves that trigger sensation in the pelvic region. You will remain awake with this type of anesthesia but will feel no discomfort. This type of anesthesia is also referred to as a ‘spinal’ or ‘epidural’.

    General anesthesia: Anesthesia will be administered with a mixture of gasses that you will inhale through your nose. You will not be conscious during the procedure if this form is used. Once completely under, a tube is inserted down your throat in order to help you breathe properly.

    Your physician will recommend the type of anesthesia that will be best for you based on the reason that you are undergoing the procedure. If any of the details of the process are unclear to you, make sure to express this and ask anything you need to in order to feel completely comfortable with moving forward.

    Once you are fully under anesthesia, the following will occur:

    1. The doctor may find it necessary to dilate the opening of the cervix.
    2. The hysteroscope will be inserted through the vagina and cervix and arrive in the uterus.
    3. The light connected to the hysteroscope will help the doctor see inside the uterus and into the openings of the fallopian tubes and uterine cavity.
    4. It will be determined whether or not surgery is required. If it is, then small instruments are inserted through the hysteroscope to do so.

    On occasion, a laparoscope may also be used in order to provide a view of the outside of the uterus. In order to see properly in this case, a gas is put into the abdomen, which will expand and allow the physician to see the organs better. Once the procedure is finished, most of this gas will be removed.

    At the end of the day, the most important factor in all of this is that the people diagnosing and performing the hysteroscopy are people you feel comfortable trusting. If this is the case, they would not recommend the procedure if they did not believe that it was going to inform them in a way that will bring them closer to understanding your current state of health. If you have any more questions about hysteroscopy for infertility and whether or not it is the best next step for you, please reach out to us, we are here to help.

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