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What is Hysteroscopy and Why Is It Done?

Hysteroscopy is used to diagnose and treat problems of the uterus. A hysteroscope is a long, thin, lighted device which is inserted into your uterus through your vagina. It projects an image on a screen and lets the physician see your uterus. Diagnostic hysteroscopic procedures have a very low complication rates, so are safe procedures with which to evaluate intrauterine pathology. Incidences of complications: intrauterine adhesiolysis 4.48%, endometrium resection 0.81%, myomectomy 0.75%, and removal of a polyp 0.38%.

Hysteroscopy and IVF

Unsuccessful IVF attempts usually are due to factors in the embryo, such as genetic problems, or issues with the woman’s uterus. Hysteroscopy is generally performed on women who have failed IVF cycles, to look for uterine growths or scar tissue and remove them or for any abnormality when detected on USG/HSG. Some clinics routinely perform the procedure on every woman before beginning IVF treatment, believing that removing polyps or scar tissue before starting IVF gave the treatment a better chance to succeed.

However, a large randomized study has found no significant difference in IVF success rates between those who had hysteroscopy before IVF and those who did not. While there is no consensus of opinion or practice yet among reproductive endocrinologists, most agree that a preliminary non-invasive test such as 3D-USG should be performed first. If an abnormality is identified, then hysteroscopy is indicated. If it is normal, then hysteroscopy is probably not necessary.