A hysteroscopy is a way for your doctor to check whether the lining, shape, and size of the uterus is affecting fertility or causing miscarriages. He or she uses a thin viewing tool called a hysteroscope. The tip of the hysteroscope is put into the vagina and gently moved through the cervix into the uterus. The hysteroscope has a light and camera hooked to it so your doctor can see the lining, or endometrium on a screen.
A hysteroscopy may be able to diagnose problems in the uterus affecting fertility, and small tools may be inserted into the uterus through the hysteroscope to fix those problems. A hysteroscopy may be used to remove uterine fibroids or polyps or may be used to open blocked fallopian tubes. If the doctor sees endometriosis in the uterus, he or she may use heated tools passed through the hysteroscope to remove the endometrium, a process called endometrial ablation; however, ablation of the uterine lining is not performed in women who wish to become pregnant because it destroys much of the lining of the uterus.
Another procedure, called a laparoscopy, may also be done at the same time as a hysteroscopy if infertility is a problem.
Complications of hysteroscopy occur in about two out of every 100 procedures. Perforation of the uterus (a small hole in the uterus) is the most common complication. Although perforations usually close spontaneously, they may cause bleeding or damage to nearby organs, which may necessitate further surgery. Uterine adhesions or infections may develop after hysteroscopy. Serious complications related to the fluids used to distend the uterus include fluid in the lungs, blood clotting problems, fluid overload, electrolyte imbalance, and severe allergic reactions. Severe or life-threatening complications, however, are very uncommon. Some of the complications above may prevent completion of the surgery.
Before undergoing hysteroscopy, patients should discuss with their physicians any concerns about the procedure and its risks.