Why is Uterine Assessment Important?
The lining of the uterus (endometrium) is where the fertilized embryo implants to result in pregnancy. This endometrium must have sufficient blood flow to support pregnancy. Uterine abnormalities (fibroids, polyps and intrauterine adhesions) may impact blood flow to and the available surface of endometrium available for implantation. A properly shaped and healthy uterine cavity is a critical factor for achieving and maintaining pregnancy.
Successful implantation begins with a structurally normal uterus and a functional endometrial lining that supports embryo attachment and development.
When planning for pregnancy, uterine assessment is an essential diagnostic step. It allows us to identify conditions that may cause infertility or contribute to recurrent pregnancy loss. Common uterine factors that may interfere with conception include:
- Endometrial polyps
- Submucosal fibroids
- Intrauterine adhesions (Asherman’s syndrome)
- Congenital uterine anomalies, such as a septate uterus
Early identification of these conditions can improve treatment outcomes and increase pregnancy success rates.
When is Uterine Assessment Recommended?
A uterine evaluation may be recommended if you:
- Have been trying to conceive without success
- Have experienced two or more miscarriages
- Have abnormal uterine bleeding, chronic pelvic pain, or known uterine abnormalities
- Are preparing for assisted reproductive treatments like IVF
- Have been diagnosed with fibroids, polyps, adhesions, or congenital anomalies
How is Uterine Assessment Performed at Reproart?
- Transvaginal Ultrasound:The initial imaging tool used to assess uterine size, shape, and endometrial lining — and, when indicated, to detect subtle abnormalities such as uterine septa, adhesions, or congenital malformations.
- Office Hysteroscopy (when needed): A thin camera is inserted through the cervix to directly view the uterine cavity. This procedure is typically done without general anesthesia and may allow minor corrections (e.g., polyp removal) during the same session.
- In some cases, screening tests such as a Pap smear or vaginal smear (bacterioscopy) may also be recommended to check for infections or cellular changes.
Office Hysteroscopy: A Closer Look
What Is Office Hysteroscopy?
Office hysteroscopy is a modern and minimally invasive method for evaluating the inside of the uterine cavity. It is performed without general anesthesia and is generally painless.
Using a very thin hysteroscope — a small tube with a camera — your doctor gently enters the uterine cavity through the cervix. A sterile saline solution is used to expand the cavity for optimal visualization.
Why Is It Done?
Office hysteroscopy is typically recommended when ultrasound suggests abnormalities such as:
- Endometrial polyps
- Submucosal fibroids
- Adhesions
- Unclear uterine contour or septum
In addition to visual assessment, the procedure may include:
- Removal of small polyps (typically up to 3 mm)
- Targeted endometrial biopsy for histological evaluation
What to Expect During and After the Procedure
- The procedure lasts about 15–20 minutes.
- Most patients do not require anesthesia.
- You may feel mild cramping or experience light spotting afterward.
- You can return to your regular activities the same day.
- Avoid intercourse for 24 hours after the procedure.
How to Prepare for Uterine Assessment
- Transvaginal ultrasound is typically performed during the early part of the menstrual cycle (days 5–10), after bleeding has ended
- No special preparation is needed for standard ultrasound
- If hysteroscopy is recommended, our team will provide specific instructions tailored to your case
- A vaginal smear (bacterioscopy) may be required
Understanding Your Results
Following your assessment:
- A normal uterine cavity supports implantation and early pregnancy
- Findings such as fibroids, polyps, adhesions, or structural anomalies may require treatment or surgical correction
Your Reproductive Endocrinologist will review the results in detail and guide you through next steps to optimize your fertility care.
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Frequently Asked Questions (FAQs)
We know that fertility care often brings up many questions — and that every journey is different. Below you’ll find answers to some of the most common questions our patients ask.
Is office hysteroscopy always needed after ultrasound?
Not always. If the ultrasound clearly identifies abnormalities, your doctor may proceed with treatment. However, when findings are unclear or further confirmation is needed, office hysteroscopy is the safest and most accurate way to evaluate the uterine cavity.
Can abnormalities be treated during office hysteroscopy?
Yes. During office hysteroscopy, small intrauterine abnormalities — such as polyps or mild adhesions — can often be treated immediately, without the need for general anesthesia or hospital admission. Office hysteroscopy is considered the gold standard for evaluating intrauterine abnormalities, offering both diagnosis and treatment in a single, minimally invasive procedure.
What is the difference between office hysteroscopy and operative hysteroscopy?
Office hysteroscopy is a minimally invasive procedure performed in a clinic without general anesthesia. It is used for diagnostic purposes and minor treatments, such as small polyp removal. Operative hysteroscopy is performed in an operating room, typically under anesthesia, and is used for more complex interventions, such as removing large fibroids or correcting uterine anomalies.
