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Why All IVF Patients Should Have a Hysteroscopy

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a blog by Jane Frederick, M.D., HRC Fertility, August 8, 2014

A hysteroscopy is the best way to see if the uterus is healthy and ready to carry a baby. During the hysteroscopy procedure, a small fiber-optic telescope is used to examine the uterus for abnormalities such as scarring and adhesions. The device allows physicians to record images of the uterus and corrects certain abnormalities.

The importance of a hysteroscopy before IVF was seen in a recent study of hysteroscopy and reproductive techniques. Out of 292 women who underwent failed IVF cycles, 25% were found to have uterine problems. These were treated by operative hysteroscopy. Improved conception rates for this group ranged from 19 to 72%. (Another study caps the higher conception rate at 45%).

Don't rely on a transvaginal ultrasound scan or HSG to pick up problems - they won't always see what a Hysteroscopy does. You got to get up close and personal. For uterine analysis, hysteroscopy is the gold standard.

Side effects after a hysteroscopy are rare. Infection happens in less than 0.4% of cases. And there's less than a 1% chance of bleeding due to uterine damage. More common side effects include a feeling of being bloated and period-like cramping. The benefit -risk ratio speaks for itself.

So why don't more clinics offer hysteroscopy as standard? The jury is out, until a more randomized controlled trial is published. In the meantime, IVF patients should request one. You want success on your first cycle.

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