Hysteroscopy for Infertility Treatment

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A hysteroscopy is a diagnostic procedure. Hystero means uterus. Scopey means to look into. This procedure is done with the help of an instrument known as hysteroscopy. It is a type of endoscope. The hysteroscopy is a long hollow tube which has a light source and a camera attached. The doctor can see the video images on the screen in front of him. With this hysteroscopy, the doctor is able to see the cervix and inside of the uterus of a patient.
Many problems of the uterus can be diagnosed with the help of hysteroscope. At the same time, some treatments can also be done at the time of hysteroscopy. It is commonly used in diagnosing various causes resulting in infertility.

Procedure:

This procedure is mostly done after the menstrual period. As around this time, the uterine lining is comparatively thin. It can be done in local, regional or general anesthesia. Patient may be sedated additionally. The patient is put in the lithotomy position. That is both the knees are bent and kept above the hips. And the perineum is near the edge of the operating table. This position is also most commonly used in vaginal birth. The diameter of the scope is more than the opening of the cervix. Hence the cervix is dilated with the help of dilators or misoprostol. Then the hysteroscope is inserted through the vagina into the cervix and then to the uterus. Normally the walls of the uterus are approximated. The uterus is then distended using fluids. And then the surgeon inspects the cavity.

Uses in Infertility:

  1. Adhesions: If there are any Adhesions in the Uterus they can be identified and removed by Hysteroscopy.
  2. Fibroids/ Polyps: The identification and exacting the location of the Polyps and Fibroids can be done by this procedure. They can also be removed by Myomectomy (for Fibroids) or Polypectomy (for polyps) in the same sitting.
  3. Uterine Abnormalities: Structural Abnormalities of the Uterus like a Septum can be diagnosed and treated.
  4. IUDs: Removal of Embedded or Misplaced IUDs can be done by Hysteroscopy.
  5. Tubal Patency Tests: The Tubal Patency can be established by using a dye with Hysteroscopy.
  6. Abnormal Uterine Bleeding: The cause of AUB can be identified and a process called as Endometrial Ablation can be done to treat it.
  7. Biopsy: A Biopsy (the small piece of tissue) can be taken from the inner lining of the uterus for further Evaluation of Uterine Pathology.
  8. Tubal Opening: If the Openings of the Tubes are Occluded, the Occlusion can be removed.

After the Procedure:

A Patient can have some Cramping, Minor Vaginal Bleeding. They can also complain of the feeling of Bloating. Some Pain Killers can be prescribed for the Post Operative Pain.

Complications:

Rarely, it can lead to perforation of the Uterus and Injury to the other Intra Abdominal Organs. This can be avoided if the Operating Surgeon is experienced and has Good Surgical Skills.

Advantages:

This is a one day procedure. Hospital stay is reduced. The patients are not given any prophylactic antibiotics. The patient has minimal pain and stress. Hence, it is also cost effective and hassle free.