A hysteroscopy is a test to examine the inside walls of the uterus.

This test is able to detect scar tissue,  polyps, fibroids, and any uterine abnormality such as a septate uterus, that may prevent an embryo from implanting properly. Having an abnormality in the uterus can also reduce the chances for pregnancy.

The Procedure

The hysteroscopy is usually done in the office and takes about 30 minutes. A speculum is inserted into the vagina (like when having a Pap smear). A local anesthetic (paracervical block) is given, and then a tiny telescope with a camera is placed through the cervix into the uterine cavity. Sterile salt water is instilled into the uterus so that  the walls can be seen. The TV monitor connected allows to visualize the inside of the cavity. We have the latest in office hysteroscopy equipment, including a 3.9 mm hysteroscope which results in significantly less discomfort.

Although some women feel some cramping, especially when the sterile salt water is instilled. Women with blocked fallopian tubes may feel more uncomfortable. Even though we are using the smallest hysteroscope available. We do recommend that one hour before the procedure you take 2-3 pills of regular ibuprofen or Diclofenac suppositories to help prevent or reduce cramps during the procedure. Apart from this discomfort, occasionally vaginal spotting or bleeding may occur. This can be managed accordingly.

Indications for office hysteroscopy :

A. Evaluation of abnormal uterine bleeding

Premenopausal ovulatory bleeding

Premenopausal anovulatory bleeding that fails medical therapy

Post-menopausal bleeding

B. Infertility evaluation

Routine infertility

Pre-IVF evaluation

Abnormal hysterosalpingogram

Recurrent miscarriage

History of Asherman’s syndrome

C. Location of intrauterine devices and foreign bodies

D. Preoperative evaluation

Grade 0, I, II submucous myomata

Asherman’s syndrome

Septate uterus

Evaluation of endometrial hyperplasia and carcinoma

E. Minor surgical procedures

Endometrial polypectomy

Adhesiolysis

Tubal recanalization

Tubal occlusion