Hysteroscopy is a minimally invasive procedure that allows direct visualization of the uterine cavity using a thin, lighted telescope-like instrument called a hysteroscope. It serves both diagnostic and therapeutic purposes in the evaluation and management of infertility and recurrent pregnancy loss.
Here are the main indications for hysteroscopy:
1. Uterine Anomalies
Hysteroscopy is used to diagnose and sometimes treat congenital uterine abnormalities such as septate uterus, bicornuate uterus, or other structural malformations that can interfere with implantation and pregnancy maintenance. The ability to directly inspect and correct these anomalies improves reproductive outcomes.
2. Recurrent Implantation Failure
For women who have had multiple failed in vitro fertilization (IVF) cycles, hysteroscopy helps detect subtle intrauterine abnormalities—like polyps, adhesions, or fibroids—that may impair embryo implantation. Surgical correction during hysteroscopy may increase the chances of successful implantation.
3. Recurrent Pregnancy Loss
Recurrent miscarriages may be linked to intrauterine pathologies such as adhesions (Asherman’s syndrome), polyps, or uterine septum. Hysteroscopy allows precise diagnosis and treatment, which can reduce miscarriage rates and improve live birth chances.
4. Intracavitary Lesions – Adhesions, Polyps
Uterine adhesions (scar tissue) and endometrial polyps can impair fertility by disrupting the normal uterine lining and embryo implantation. Hysteroscopy is the gold standard for detecting and removing these lesions effectively in the same session, making the uterus more receptive to pregnancy.
Additional Indications
- Abnormal uterine bleeding
- Suspicion of retained products of conception
- Evaluation of infertility when other imaging is inconclusive
Conclusion
Hysteroscopy plays a pivotal role in modern fertility treatment by enabling direct visualization and treatment of uterine factors contributing to infertility or pregnancy loss. Its minimally invasive nature, combined with diagnostic precision and therapeutic potential, makes it a valuable procedure for women experiencing unexplained infertility, recurrent implantation failure, or recurrent pregnancy loss. Discuss with your fertility specialist to understand if hysteroscopy is recommended in your case.