Our medical team
Hysteroscopy
What is a hysteroscopy?
A hysteroscopy is the examination of the inside of a woman’s womb with a fine ‘telescope’ in order to check that the cavity and lining of the womb is normal.
How does it work?
A hysteroscopy involves a small telescope being inserted into your womb through the vagina (birth canal) and cervix (neck of the womb) so that a doctor can examine the inside of your womb.
A local anaesthetic or general anaesthetic may be used so you will not feel any pain during the procedure, but most women do not need an anaesthetic. Some women experience cramping during the procedure.
During a hysteroscopy, it is usual to remove a small piece of the lining (endometrial biopsy) for testing – a number of tests can be performed, and your physician will discuss with you which are most appropriate in your case.
Who is a hysteroscopy for?
At Bourn Hall, we recommend hysteroscopy in the following patient groups:
- Where there is a history of three previous biochemical or failed clinical pregnancies (miscarriages)
- Women who have had three or more IVF treatment failures with transfer of one or two embryos of good quality each time
- Women who have had one or more uterine interventions in the past, such as termination of pregnancy, evacuation of retained products of conception, manual removal of the placenta, hysterotomy or complicated caesarean section
- Women who have had a myomectomy (removal of a fibroid) or who have had hysteroscopic removal of a uterine cavity fibroid who have not had a follow-up hysteroscopy
- Women with menstrual abnormalities, such as intermenstrual bleeding, pre-menstrual or post-menstrual bleeding or prolonged spotting of blood
- Women with any known endometrial abnormalities which have been noted on ultrasound in the past or in previous treatment cycles
- Women with abnormalities of the endometrium found on ultrasound examination at the time of the ‘baseline’ study, during the monitoring stage of a treatment cycle, or when the endometrium is found to be abnormally thin or abnormally thick
- Women who have known abnormalities of the uterine cavity, such as severe or moderate degrees of double uterus or a uterine septum
- Women with a history of two or more difficult embryo transfers in previous treatment cycles
Why should you consider having a hysteroscopy?
The majority of women have normal structure and function of the womb and the endometrium (lining of the womb), both of which are essential for the success of IVF and related treatments.
However, some women will have uterine or endometrial abnormalities that may be contributing, not only to their infertility, but may also lead to failure of embryos to implant in the womb or to miscarriage.
Some of these abnormalities, if confirmed on diagnostic hysteroscopy, are treatable and would improve the chance of successful fertility treatment. Some women with untreatable or difficult to treat pathologies will, nevertheless, be in a better position to make decisions about their treatment based on sound information.
At Bourn Hall it is standard practice to assess the normality of the uterus and endometrium of a patient undergoing IVF by transvaginal ultrasound, which is done as an initial screening test. In most cases, this is sufficient to obtain information that is reassuring before proceeding with IVF treatment. However, ultrasound examination has only a limited ability to assess the endometrium when compared to hysteroscopy and, on its own, may in some cases lead to a false impression that the womb is normal.
