Diagnostic hysteroscopy in assisted reproduction
A hysteroscopy is one of the tests we use in assisted reproduction clinics to examine the uterine cavity and diagnose fertility issues when necessary.
Maybe you’ve heard of this diagnostic test but you’re not quite sure what it involves. That’s why in this article we want to clear up doubts about the hysteroscopy and explain to you what it is, what types there are and how we carry out the procedure in our fertility clinic in Spain.
What is a hysteroscopy?
A hysteroscopy is an examination of the uterine cavity using an optical system. This system is introduced into the cervix and allows us to visualise the cervical canal, endometrial cavity and the orifices which open into the fallopian tubes.
To obtain a better view, a gas or liquid is used during the examination to help distend the uterine cavity.
What types of hysteroscopy are there?
We can differentiate between two types of hysteroscopy procedures, and we will explain each one below:
First is the diagnostic hysteroscopy which is performed for the sole purpose of visualising the inside of the uterine cavity. This procedure is carried out in the doctor’s consultation and generally does not require anaesthesia, though in some cases local anaesthesia may be used.
The second type is the surgical hysteroscopy which is used when a surgical intervention is required. In these cases there is a previous diagnosis and the purpose of the procedure is to correct an existing problem.
With a surgical hysteroscopy anaesthesia will be administered to the patient. This means that the intervention will be performed in the operating theatre and requires the patient to be admitted to the hospital, though she is normally discharged the same day.
How is the diagnostic hysteroscopy performed?
As we said above, a hysteroscopy involves introducing an optical system into the uterine cavity at the same time a gas or liquid is administered in order to enlarge the cavity and enable visualisation.
This diagnostic procedure is generally well‑tolerated by patients, has very few complications and does not require hospital admission.
The diagnostic hysteroscopy is normally carried out between the end of menstruation and ovulation, though it’s possible to perform this procedure at any time during a woman’s cycle.
When is a diagnostic hysteroscopy indicated?
This test is used to confirm or rule out a diagnosis of polyps, submucosal fibroids (fibroids inside the uterine cavity), intrauterine adhesions (Asherman’s Syndrome) or malformations of the uterus (uterine septum, subseptate uterus, T-shaped uterus, directly visualise an intrauterine device…).
A hysteroscopy may also be performed for the study of abnormal uterine bleeding, in cases where infertility is suspected to have a uterine or endometrial cause, recurrent miscarriage, implantation failure in IVF cycles, etc.