Hysteroscopy is a Pre IVF-ICSI procedure it is the best way to check your womb is healthy and ready to carry a baby. You wouldn’t bake a cake before checking the oven worked, would you? Same rules apply to IVF cycles. Hysteroscopy is the checker.
During this procedure, you’ll be sedated or put under general anesthesia. Then a narrow tube with a telescope at the end is passed through your vagina and cervix into your uterine cavity, which is sometimes filled with fluid or gas. The images are viewed on a screen and recorded. The surgeon can then check for fibroids, polyps, scar tissue, septa, adhesions and other malformations. If any are spotted, they can usually be sorted out at the same time – i.e. your hysteroscopy changes from being diagnostic to operative. At the same time the endometrium can be sent to test for TB PCR.
Laproscopy Hysteroscopy before IVF
Patients who have been diagnosed with unexplained infertility, endometriosis, or fibroids, or those who have had a failed IVF cycle might be candidates for corrective reproductive surgery before moving on to more advanced treatments like in vitro fertilization (IVF-ICSI).
During this process you’ll probably have a general anesthesia. A small incision will be made in your abdomen (small is good for risk reduction and recovery). A thin tube, with light and camera attached, is guided into your pelvic area. Secondary incisions may also be made nearby, allowing small surgical tools and gas to be pumped in, creating a better view of your reproductive organs. The aim is to seek out cysts, fibroids, endometriosis, ectopic pregnancies, pelvic inflammatory disease, adhesions, infections and other nastiest that may be affecting your fertility. The whole show lasts up to 90 minutes, depending on what’s done.
A laparoscopy can therefore be operative, not just diagnostic. Meaning that if they find something, they can deal with it there itself. Some tubal repairs may be unnecessary in the face of IVF technology. But if you’ve had one or two failed IVF cycles, you’ll want to do everything you can to get to the root of the problem. That problem may well be to do with the receptivity of your uterine lining – and that’s where a laparoscopy might just help.
Initial Consultation with Renova Fertility Specialist
Pros and Cons of Hysteroscopy
Hysteroscopy and IVF
Unsuccessful IVF attempts usually are due to factors in the embryo, such as genetic problems, or issues with the woman’s uterus. In the past many fertility clinics routinely performed hysteroscopy on women who had failed IVF cycles, to look for uterine growths or scar tissue and remove them. There are other, non-invasive methods of assessing the uterine cavity including hysterosonography (HSN) where a small amount of salt water is infused into the uterus and an ultrasound is performed to assess the uterus. Typically hysteroscopy is reserved for cases in which an abnormality has been identified on the HSN or HSG.
Risks of Hysteroscopy
Complications of diagnostic hysteroscopy are rare and seldom life-threatening. Perforation of the uterus is the most common complication, but the hole usually heals on its own, without requiring additional surgery. When operative hysteroscopy is planned, diagnostic laparoscopy is frequently performed at the same time to allow the physician to see the outside as well as the inside of the uterus.