What is Hysteroscopy, and How is it Used in Infertility Evaluation and Treatment?

Dr. Marika Raff • December 2, 2024

At Caperton Fertility Institute, we know that every step of your fertility journey matters. Whether you're in the early stages of evaluation or exploring advanced treatments, understanding the tools and techniques we use can help you feel empowered and informed. One of the essential procedures we use in both diagnosing and treating infertility is called hysteroscopy.

A woman with long hair is smiling in front of a rainbow.

Hysteroscopy is a minimally invasive technique that allows us to see directly inside the uterus to identify and, in many cases, treat issues that could be impacting your fertility. If you've been recommended for a hysteroscopy, or if you're curious about how it supports fertility care, here’s everything you need to know.

What is Hysteroscopy?

Hysteroscopy involves inserting a thin, lighted camera (called a hysteroscope) through the cervix and into the uterus. This allows us to directly visualize the uterine cavity in real-time, providing detailed insights into its health and structure.

The procedure is typically performed on an outpatient basis and may be diagnostic(to examine the uterus for abnormalities) or operative(to treat issues identified during the evaluation). Read more about the role of hysteroscopy in fertility therapy.

How is Hysteroscopy Used in Infertility Evaluation?

The uterine cavity plays a critical role in conception and pregnancy. An irregularly shaped uterus or certain abnormalities within the uterine cavity can interfere with embryo implantation or increase the risk of miscarriage. Hysteroscopy allows us to investigate and address these issues. Learn how hysteroscopy improves reproductive outcomes in infertile couples.

1. Diagnosing Uterine Abnormalities

Hysteroscopy provides a clear view of the uterine cavity, helping detect structural abnormalities or conditions such as:

  • Polyps: Overgrowths of the endometrial lining that may interfere with implantation.
  • Fibroids: Noncancerous growths in the uterus that can distort the uterine cavity or block the fallopian tubes.
  • Adhesions (Asherman’s Syndrome): Scar tissue in the uterus that prevents the uterine lining from developing properly, impacting implantation.
  • Septum or Congenital Uterine Abnormalities: A division in the uterus caused by incomplete development during embryogenesis, increasing the risk of miscarriage or infertility.
  • Chronic Endometritis: Inflammation of the uterine lining, often caused by infection, which may prevent a healthy pregnancy.

Explore the role of hysteroscopy in diagnosing uterine abnormalities.

2. Investigating Recurrent Pregnancy Loss

If you’ve experienced recurrent miscarriages, hysteroscopy can uncover uterine factors contributing to pregnancy loss. By addressing these issues, we optimize the uterine environment for future pregnancies.

3. Enhancing Fertility Treatment Success

Before undergoing treatments like in vitro fertilization (IVF), ensuring a healthy uterine cavity is crucial. Hysteroscopy allows us to identify and treat issues that could negatively affect embryo implantation during IVF. Understand the evidence supporting hysteroscopic surgery in fertility care.

What to Expect During a Hysteroscopy

Hysteroscopy is a safe and straightforward procedure. Here’s what you can typically expect:

Before the Procedure

You may be asked to avoid eating or drinking for several hours beforehand, especially if sedation or anesthesia is required.

During the Procedure

A hysteroscopy can be performed in the office. You can choose to remain awake or receive moderate sedation. The hysteroscope is gently inserted through the cervix into the uterus, and saline is used to expand the uterine cavity for better visualization.

After the Procedure

Most patients return home the same day and resume normal activities within 24-48 hours. Mild cramping or spotting is common for a day or two. Review a study on reproductive outcomes after hysteroscopy.

Why Hysteroscopy is Important in Fertility Care

At Caperton Fertility Institute, we use the latest technologies to give our patients the best possible outcomes. Hysteroscopy is a cornerstone of modern fertility care because it allows us to precisely identify and correct issues impacting your ability to conceive.

For many patients, addressing uterine abnormalities through hysteroscopy improves their chances of achieving a healthy pregnancy—whether naturally or with assisted reproductive techniques like IVF.

Dr. Marika Raff is a board-certified fertility specialist at Caperton Fertility Institute, where she helps individuals and couples overcome fertility challenges with state-of-the-art treatments and compassionate care.

A person is looking through a microscope at a petri dish.
By Dr. Marika Raff June 12, 2025
Embarking on the embryo transfer phase of your IVF journey is a big step, and understandably, patients often ask what they can expect during this important stage. At Caperton Fertility Institute, we take great care in preparing your body to create the most welcoming environment possible for a developing embryo. Here’s an overview of how we prepare you for a frozen embryo transfer, including the medications we use and why they matter. 1. Estrogen Patches to Build the Uterine Lining The first step in the preparation process involves thickening the endometrial lining of your uterus so it can support an embryo. We use estrogen patches for this purpose. These patches deliver a consistent dose of estrogen through your skin, and you’ll typically wear several patches on your abdomen at a time, changed every other day as instructed. Estrogen helps your uterine lining grow to the ideal thickness for implantation. We monitor this closely with ultrasound to ensure optimal conditions. 2. Adding Intramuscular Progesterone Once your lining has reached the right thickness, we introduce intramuscular progesterone injections. Progesterone transforms the uterine lining into a receptive state, mimicking what happens naturally after ovulation. These injections are given daily and are an essential part of making the uterus ready to accept an embryo. While the thought of intramuscular shots can be intimidating, our team will guide you through every step and offer tips to make the process more comfortable. 3. Timing the Transfer The timing of your embryo transfer is carefully coordinated based on your hormone levels and the day your embryo was frozen. For example, if you're transferring a blastocyst (an embryo that developed for five days), we schedule your transfer five days after starting progesterone. Precision is key, and we tailor the timing to closely replicate the conditions of a natural cycle. 4. Day of the Transfer The transfer itself is a quick, gentle procedure that doesn’t require anesthesia. We use ultrasound guidance to place the embryo in the uterus, and many patients describe it as similar to a Pap smear. Afterward, you’ll rest briefly before going home. Supporting You Through Every Phase Every part of the embryo transfer preparation is designed with care and intention. We want to give you the best possible chance for success, and we’re here to support you emotionally and physically throughout the process. If you have any questions about preparing for your embryo transfer or the medications involved, don’t hesitate to reach out. We’re with you every step of the way.
Learn how long the IVF egg retrieval process takes, step-by-step, from ovarian stimulation to recove
By Dr. Lee Caperton May 5, 2025
Learn how long the IVF egg retrieval process takes, step-by-step, from ovarian stimulation to recovery. Expert insight from Caperton Fertility Institute in Albuquerque and El Paso.
Discover what it means to become an egg donor at Caperton Fertility Institute. Learn about the proce
By Dr. Marika Raff May 5, 2025
Discover what it means to become an egg donor at Caperton Fertility Institute. Learn about the process, qualifications, benefits, and life-changing impact of IVF egg donation.
More Posts