What is Hysteroscopy?

Hysteroscopy is a medical procedure done to examine the inside of a woman’s uterus (womb) to diagnose and treat the issues found inside, such as abnormal bleeding, fibroids, polyps, adhesion, etc. 

Hysteroscopy for infertility is done to diagnose and treat the cause of repetitive miscarriages and not being able to get pregnant. 

For Hysteroscopy, a thin and flexible telescope with a light and camera at the end known as a Hysteroscope is inserted into the uterus through the vagina and cervix. Images of the uterus are displayed on a screen, which allows the doctor to have a clear view of the inside (womb). In case of a treatment, other instruments are used with the hysteroscope.

Why is Hysteroscopy for infertility done?

There are various reasons, due to which a woman might get a Hysteroscopy done. It may be required for-

• Abnormal uterine bleeding-

Finding the cause of abnormal bleeding is one of the most common reasons for getting a Hysteroscopy done. Abnormal bleeding could mean- long and very heavy periods, bleeding between periods, postmenopausal bleeding (bleeding after menopause)

To treat abnormal bleeding, the uterus lining is destroyed with the help of a procedure known as endometrial ablation, which requires the use of hysteroscopy along with other instruments.

• Fibroids and Polyps- Fibroids and Polyps are non-cancerous growths in the uterus, which could have been identified at the time of an ultrasound scan. These can also be the cause behind abnormal bleeding and are removed with the help of a Hysteroscopy.

•  Adhesions- Hysteroscopy is used to locate and remove bands of scar tissues in the uterus, known as uterine adhesions or Asherman’s Syndrome. They are formed due to some infection or from surgery in the past and can cause abnormal periods and infertility as well.

• Pregnancy issues- Hysteroscopy is also used to diagnose and treat the issues behind repeated miscarriages, and infertility.

• • Finding IUDs- IUD, intrauterine devices are inserted in the reproductive system of a woman to avoid pregnancy. Via hysteroscopy, these IUDs are either removed (if the woman wants to conceive) or replaced in case they get displaced (if the woman doesn’t want to conceive ).
• Biopsy- Hysteroscopy is also used to get a small tissue sample (biopsy) from the uterus for further assessment.

What is the procedure of Hysteroscopy?

Hysteroscopy is done on an outpatient, which means that the patient is not required to stay overnight at the hospital. The procedure might take 10 minutes or one hour depending upon whether it is being done for just diagnosis or treatment. 

• For hysteroscopy, you might be given local anesthesia to numb the cervix area. In case you need to undergo treatment along with diagnosis, the doctor may give you local anesthesia.
• Hysteroscopy does not require any cuts, the hysteroscope is inserted in your uterus through the vagina and cervix. Before that, a tool called a speculum is used to keep your vagina open, and a dilator or medication is inserted into the cervix to keep it open.
• Through the hysteroscope, carbon dioxide gas or a saline liquid solution is inserted into your uterus to expand it and get a look at the uterus lining.
• A small light on the head of the hysteroscope allows the doctor to have a clear view of your uterus and the opening of the fallopian tubes.
• If there are no issues, hysteroscopy will not take more than 10 minutes. However, if treatment needs to be done, like for removing fibroids, polyps, adhesions, etc, small instruments will be put inside your uterus through the hysteroscope. This procedure might last for an hour or more.

After getting Hysteroscopy, you can go home soon, but if you had a treatment and were given general anesthesia, you might have to stay at the hospital for a couple of hours.

What are the risks involved in Hysteroscopy?

Generally, Hysteroscopy is a safe procedure, however, like any other medical procedure, it comes with some risks and complications. And the risk increases if a treatment is performed along with the diagnosis. The risks are-

• Infection
• Excessive bleeding
• Tearing or damaging of the uterus or cervix (rare)
• Pelvic inflammatory disease
• Complications caused due to gas or fluid used to expand the uterus
• Injury to nearby organs like bowel, bladder or ovaries. 

You might also experience minor vaginal bleeding and cramps for not more than 2 days after Hysteroscopy. 

In case you get a high fever, heavy bleeding, severe pain in the abdomen, post-procedure, you should immediately call your doctor or go to the hospital.

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