Features of hysteroscopy before IVF

In preparation for IVF, a woman undergoes a lot of examinations and passes a large number of tests. This is not a fad of medical institutions, but a real necessity: the doctor must be well aware of the difficulties that may arise in the course of artificial insemination of a particular patient. One of the most important and informative analyzes is hysteroscopy. What is this survey, how is it carried out and what does it show, we will tell in this material.

Hysteroscopy of the uterus - a method of instrumental rapid diagnostic examination. It is made in order to have a comprehensive idea of ​​what the state of the uterus of a woman, her inner functional layer, is. It is very important to assess the probability of success of the procedure. With a thinned endometrium, with an uneven and thin functional layer, the probability of implantation of implanted embryos, alas, is low.

RHysteroscopy before IVF is done in order to know for sure whether a woman can become pregnant and carry out a child. Also, this examination is considered mandatory after an unsuccessful IVF attempt. It will help to establish the reasons for which the pregnancy did not take place.

Hysteroscopy is carried out with the help of special equipment - a hysteroscope, which is a very thin and elegant probe with an integrated optical system. At the end of the probe there is a tiny video camera that will broadcast the image to the monitor. The probe is inserted into the uterine cavity through the cervical canal.

For diagnostic purposes, hysteroscopy is made the thinnest probes, the diameter of which does not exceed 7 mm. This procedure is practically painless for the patient and in most cases does not require the use of anesthesia. The survey, though not the most pleasant, but not painful and not long. The cervix is ​​not enlarged in it, if a woman has a heightened sensitivity, she can be given pain relief.

Wider hysteroscope probes that are wider in diameter are used in operative hysteroscopy, when it is necessary not only to conduct a visual inspection of the endometrium and the walls of the uterus, but also to take tissue samples for biopsy analysis.

Sometimes there is a need not only to do a biopsy, but also to conduct a hysteroscopy with scraping, in order not only to assess the condition, but also to remove some nodes, adhesions, tumors.

After hysteroscopy for diagnostic purposes, if no pathologies have been identified, IVF can be done in just 15-30 days, that is, in the next menstrual cycle. If pathologies have been identified, time is required to carry out a preliminary treatment, if doctors consider it appropriate.

After a hysteroscopy with an IVF biopsy, it can be prescribed in about 2–3 months, and after the procedure with curettage, IVF is planned no earlier than six months. In each case, the doctor prescribes the terms of the protocol of in vitro fertilization after hysteroscopy, taking into account individual risks and examination results.

Hysteroscopy is a great help for fertility doctors. We can safely say that it increases the chances of a successful IVF, because it allows the doctor to know all the "weak" places of the female body. Appointed examination is not always, but only for certain indications, including:

• infertility caused by habitual miscarriage (several miscarriages or missed abortion in history);
• infertility caused by endometriosis;
• infertility on the background of several abortions in history;
• if the doctor suspects polyps, adhesions, damage to the mucous membranes after surgery;
• infertility against the background of uterine fibroids;
• idiopathic infertility, the cause of which is not established;
• infertility associated with violations of the regular menstrual cycle.

Hysteroscopy is required after several unsuccessful IVF attempts. The effectiveness of hysteroscopy is considered very high, the survey belongs to the category of high-precision.

They try not to perform hysteroscopy if a woman has malignant tumors in the uterus or severe stenosis of the cervical canal.

The diagnostic procedure is not carried out for women who are sick at the time of the examination with influenza, ARVI or any other disease - time is required for recovery, after that the temporary ban will be lifted and the woman will be able to get tested.

Contraindications to the procedure are some diseases of the blood vessels and the heart, as well as uterine bleeding at the time of hysteroscopy. A relative contraindication is the absence of pregnancy and childbirth in history.

Before hysteroscopy, a woman must pass all tests prescribed by the doctor. Usually, general blood and urine tests, a biochemical blood test, and a vaginal smear for microflora and infection are prescribed. With positive results of laboratory diagnosis, the woman is sent to an ultrasound of the pelvic organs. And only then can she undergo hysteroscopy of the uterus.

Before IVF, hysteroscopy is prescribed from the 6th to the 10th day of the menstrual cycle, the report is conducted from the first day of the last menstruation. There is no need to go to the hospital for examination. If hysteroscopy is performed only as a diagnostic and is not accompanied by a biopsy or scraping, then the woman will be in the clinic for no more than three hours. The procedure itself takes about 10-15 minutes.

After curettage, the hospital stay can last up to a day or a little more if any complications develop. The procedure in this case can take up to an hour. By the way, the probability of complications after the procedure is not so high - no more than 1%.

Before hysteroscopy for 12 hours, a woman is recommended to refrain from eating. On the day of the procedure, an enema should be performed, the bowels should be emptied, and the bladder should be emptied half an hour before the procedure. Taking aspirin and any acetylsalicylic acid-based drugs is prohibited at least one week before hysteroscopy to avoid bleeding.

As already mentioned, the doctor recommends hysteroscopy for not all women who will have IVF. The modern approach of the World Health Organization to this issue is somewhat different - this organization strongly recommends that hysteroscopy be performed on all those who use IVF. Firstly, this will improve the protocol, since there will be more initial information from a fertility specialist. Secondly, it will save patients time and money.After an unsuccessful attempt, hysteroscopy will still have to be done, and it is better to do it before the first attempt to increase the chances of becoming pregnant.

If your doctor has not prescribed hysteroscopy, you can contact him with this question and ask him to add an examination to the prescription before IVF. This is a woman’s right.

Make a hysteroscopy on prescription is completely free. It is carried out in most public hospitals and clinics, as well as on the basis of women's clinics. However, be prepared for the fact that the queue for the procedure will be impressive.

If you need to make an examination faster, you should contact the private clinic, which provides such services. The cost may be different - from basic 4-7 thousand for the diagnostic procedure to 30 thousand rubles for hysteroscopy with RFE and subsequent histological analysis of tissues from the uterus. The best option for a woman planning IVF is to do a hysteroscopy with the doctor who will plan the IVF protocol.

The most positive feedback from women about office hysteroscopy, which for diagnostic purposes can be done right in the office of an obstetrician-gynecologist at a gynecological cross. It is fast, not painful and quite informative.

According to women who have gone through this procedure, hysteroscopy with scraping significantly increases the chances of pregnancy. Most women, after an unsuccessful attempt and follow-up procedure, manage to become pregnant in the second or third protocol.

For information on what are the features of hysteroscopy before IVF, see the following video.