What is hysteroscopy and how is it done

It is a special examination that allows us to observe the uterine cavity, the endometrium, the uterine openings of the fallopian tubes and the canal of the cervix. It is almost painless and last a few minutes. In few cases of highly stressed patient we can administer mild anesthesia (sedation). The uterine cavity is approached via the vagina and cervix, without a section or injury. This is achieved using a hysteroscope, a kind of telescope of small diameter 2.9 mm. A special camera of small weight is attached to the hysteroscope for the imaging and recording of the operation.

What is hysteroscopy useful for

Hysteroscopy offers the possibility to directly observe the uterine cavity for an accurate diagnosis. Using hysteroscopy we can examine:

• The morphology (size and shape) of the uterine cavity
• The uterine openings of the fallopian tubes
• The structure and development of the endometrium
• The cervical tube (endocervix)

Hysteroscopy has an advantage over hysterosalpingography in sensitivity and specialization in investigating infertility and repeated miscarriages. Hysteroscopy is a valuable tool for the diagnosis and treatment of infertility, as 62% of infertile women has been found to display endometrial cavity pathology.

When it is recommended in infertility

Hysteroscopy is recommended:

• For the specification of hysterosalpingography or ultrasound findings concerning adhesions, polyp, fibroids, congenital abnormality.
• After repeated miscarriages.
• After two consecutive unsuccessful IVF cycles.
• In history of miscarriages, abortions and operations to the uterine cavity.
• To investigate unexplained infertility combined with laparoscopy.
• As a routine method before IVF (it is recommended by several specialists), especially in the absence of hysterosalpingography.

A significant percentage of women with normal hysterosalpingography demonstrate endometrial cavity pathology when subjected to hysteroscopy.