Learn what a hysteroscopy is and how hysteroscopy is used for IVF and infertility diagnostics.
Hysteroscopy is a medical procedure that helps healthcare providers examine a woman's uterus using a thin, illuminated tube called a hysteroscope. Hysteroscopy is the preferred procedure for both diagnosing (diagnostic hysteroscopy) and treating (operative hysteroscopy) uterine issues.
Hysteroscopies are typically performed for the following reasons:
Hysteroscopy is generally performed as an outpatient procedure, and you should be able to go home afterward; however, if you received general anesthesia, you may need to wait until you are less groggy to return home.
After hysteroscopy, it is normal to have some mild cramping or light bleeding for a few days and up to a week. Additionally, some patients report pain from gas in the digestive tract. Medication may be provided for pain control. In the unlikely event of a fever or heavy bleeding, call your healthcare professional immediately.
Hysteroscopy is generally a very safe procedure; however, there are a few risks. The number of problems that people experience post hysteroscopy can vary widely and have been reported as <1% of patients in several studies. Of those complications, the most commonly reported include hemorrhage (2.4%), uterine perforation (1.5%), and cervical laceration (1–11%). Nonetheless, the majority of research indicates a high level of safety and patient satisfaction following operative hysteroscopy.
Hysteroscopy is an important part of infertility examinations. A hysteroscopy helps find growths like fibroids, polyps, and adhesions in the uterus, which are common in women of reproductive age, representing 2-3% of causes of infertility. Growths can cause infertility by getting in the way of the implementation and growth of an embryo in the womb. In fact, studies show that the most common uterine abnormalities are detected by hysteroscopy in 10-15% of women who are looking for medical treatment for infertility.
In addition to detecting abnormalities in the uterus, hysteroscopy prior to IVF has been suggested to improve IVF success rates. A Cochrane systematic review revealed that in women undergoing IVF, the included studies showed that performing a screening hysteroscopy first improved the chances of live birth or clinical pregnancy. More specifically, for women trying to conceive at a traditional fertility clinic with a 22% live birth rate, a screening hysteroscopy may potentially increase live birth rates to 25%- 32% without raising the risk of miscarriage.
However, it's important to understand that the quality of these studies was poor, and there is also a lack of evidence regarding any problems that might happen during or after a hysteroscopy. Higher-quality studies are needed to determine the usefulness and safety of hysteroscopy before IVF.
Working with your healthcare professional to determine the best tools for you in screening for potential intrauterine issues is necessary. Find fertility specialists near you If you are looking for a second opinion or need to do fertility testing.