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Saline Sonohysterogram
If your Team RMI physician suspects that there may be a uterine factor for infertility, by your clinical history or based on previous imaging, a Hysteroscopy may be recommended.

What to expect: A hysteroscopy is a minimally invasive, same-day surgical procedure aimed at not only evaluating the uterine cavity, but also at correcting any abnormality that may have been discovered through other diagnostic testing, such as a sonohysterogram, ultrasound, or hysterosalpingogram.  This procedure requires intravenous (IV) anesthesia and is performed in a surgical center. 

How the procedure is done: Occasionally, your provider may want you to take medications to prepare the uterus for the surgery.  During the procedure, your doctor will place a sterile speculum into the vagina in order to visualize and clean the cervix.  Then, your provider will use special instruments to gently dilate the cervix in order to pass a small hysteroscope (long, thin camera) into the uterus.  Fluid is also instilled into the uterus in order to allow your provider the visualize the cavity.  Initially, an anatomic survey is completed, identifying any abnormalities which may affect your fertility.  If the presence of an abnormality is confirmed (such as an endometrial polyp, uterine fibroid, or uterine septum), your provider will use additional specialized instruments to remove the abnormality under direct visualization with the camera. 

What are the risks? The major risks for hysteroscopy include bleeding, infection, fluid overload, uterine perforation (making a small hole in the uterus), and future development of scar tissue.  Overall complications are rare (occurring in about 2 out of every 100 procedures), but if they do occur they prevent completion of the original surgery and may require additional surgery in the future.  Since this procedure is same day surgery, the recovery is fairly minimal.

What this procedure tells you: A Hysteroscopy is the inspection of the uterine cavity with an endoscope (camera) with access through the cervix.  The benefit of hysteroscopy is that it serves both a diagnostic as well as therapeutic purpose, and can be useful for women with uterine pathology, recurrent pregnancy loss, recurrent implantation failure, and abnormal uterine bleeding.
For more information on Hysteroscopy:

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