Pre IVF Hysteroscopy is a day care procedure done under short general anesthesia in operating theater. It is done to evaluate the uterine cavity and the entry of the womb it is performed soon after menstruation has ended either during the first visit or before stimulation.
Hysteroscopy is a useful procedure to evaluate women with infertility, recurrent miscarriage, or abnormal uterine bleeding. Diagnostic hysteroscopy is used to examine the uterine cavity (Figure 3), and is helpful in diagnosing abnormal uterine conditions such as internal fibroids, scarring, polyps, and congenital malformations. A hysterosalpingogram (an x-ray of the uterus and fallopian tubes), sonohysterogram (ultrasound with introduction of saline into the uterine cavity), or an endometrial biopsy may be performed to evaluate the uterus prior to hysteroscopy.
The first step of diagnostic hysteroscopy usually involves slightly stretching the canal of the cervix with a series of dilators to temporarily increase the size of the opening of the cervix. Once the cervix is dilated, the hysteroscope (a long, thin, lighted, telescope-like instrument) is inserted through the cervix and into the uterus. Skin incisions are not required for hysteroscopy. Carbon dioxide gas or special fluids are then injected into the uterus through the hysteroscope. This gas or fluid expands the uterine cavityand enables the physician to directly view the internal structure of the uterus.
Diagnostic hysteroscopy is an outpatient procedure that is performed in a physician's office or operating room. It is performed soon after menstruation has ended because the uterine cavity is more easily evaluated
Operative hysteroscopy can treat many of the abnormalities found during diagnostic hysteroscopy. Operative hysteroscopy is similar to diagnostic hysteroscopy except that narrow instruments are placed into the uterine cavity through a channel in the operative hysteroscope. Fibroids, scar tissue, and polyps can be removed from inside the uterus. Congenital abnormalities, such as a uterine septum, may be corrected through the hysteroscope.
Your physician may want you to take medications to prepare the uterus for surgery. At the conclusion of surgery, your physician may insert a Foley catheter or other device inside the uterus. Antibiotics and/or estrogen may be prescribed after some types of uterine surgery to prevent infection and stimulate healing of the endometrium.
Endometrial ablation, a procedure in which the lining of the uterus is destroyed, can be used to treat some cases of excessive uterine bleeding. Ablation of the uterine lining is not performed in women who wish to become pregnant. For more information on this topic, please refer to the Narmada Patient Fact Sheet "Endometrial Ablation".
Risks of Hysteroscopy
Complications of hysteroscopy occur in about two out of every 100 procedures. Perforation of the uterus (a small hole in the uterus) is the most common complication. Severe or life-threatening complications, however, are very uncommon.
Following hysteroscopy, some vaginal discharge or bleeding and cramping may be experienced for several days. Most physical activities can usually be resumed within one or two days. You should ask your physician when to resume sexual intercourse. If a Foley catheter is left in the cavity, it is usually removed after several days. Estrogen may be prescribed for several weeks after surgery.