Hysteroscopy is the procedure to evaluate the uterus from inside, using a telescope with a camera attached to it. Hysteroscopic examination can be diagnostic as well as therapeutic, which means that if there is any correction needed inside the uterus it can be done at the same sitting. Hysteroscopy should be done in patients with repeated IVF failures, or when there is any lesion spotted inside the uterus, noticed during ultrasound examination, which needs correction. We prefer doing hysteroscopy for all cases of IVF before embryo transfer, especially in those with repeated IVF failures. If we suspect any endometrial pathology we may do a histopathology exam or PCR test of the endometrial tissue ,to rule out genital TB .
In recent times, we normally do ovum pick up and freeze all the embryos. After one or two months we plan the embryo transfer. Just prior to the expected menstrual period of the patient , we perform the hysteroscopy . This serves the dual role of examining the cavity , correcting any problems in the cavity if necessary and stimulating the endometrium (like a pipelle effect) to give better pregnancy results.