Hysteroscopy
A therapeutic hysteroscopy is a procedure in which the doctor can look into you uterus and guide a laser or electrocautery resectoscope into the uterus. The doctor can use this procedure to remove the uterine lining. Your uterus is the muscular organ at the top of the vagina where menstruation begins and babies grow. In a diagnostic hysteroscopy, the doctor will simply look inside the uterus, and perhaps take a small biopsy.
When is hysteroscopy used?
This operation may be performed when you have consistent bleeding from the uterus even after trying other procedures to control it. You may have excessive growth in the lining of your uterus, or your ovaries may not be working well.
How do I prepare for therapeutic hysteroscopy?
Plan for your care and recovery after the operation, especially if you are going to have general anesthesia. Allow for time to rest and do you best to get help with your day-to-day duties from friends and/or family.
Follow the instructions provided to you by your doctor. No special preparation is needed for local or regional anesthesia. If you are scheduled to have general anesthesia, eat a light meal, such as a soup or salad, the evening before the procedure. Do not eat or drink anything after midnight the day before the procedure. This restriction applies even to coffee, tea, and water.
What happens during the procedure?
You are given a local/regional or general anesthetic. A local or regional anesthetic numbs part of your body while you remain awake. It should keep you from feeling pain during the operation. A general anesthetic relaxes your muscles, makes you feel as though you are in a deep sleep, and prevents you from feeling pain.
The doctor dilates your cervix and then places a hysteroscope (a thin, telescope-like tube with a light source) up through the cervix into the uterus. The uterus is then inflated with fluid or gas. This allows the doctor to view the inside of the uterus. The doctor may use a laser or an electrocautery resectoscope to remove the lining of the uterus if he or she feels it would be beneficial to your condition.
What happens after the procedure?
If you have the procedure done in your doctor's office, he or she will ask you to rest for about 10 minutes before leaving. You may want to have someone come with you to drive you home since you may have some cramping and discomfort after the procedure.
After the procedure you may expect to:
- feel sleepy or groggy from the general anesthetic
- have some cramps
- retain more urine than before
- have a watery discharge for 3 or 4 weeks afterwards
Ask your doctor what steps you should take and when you should come back for a check-up.
What are the benefits of this procedure?
This procedure enables your doctor to diagnose the cause for abnormal bleeding, pain and discomfort. The biopsies taken during this procedure can provide useful information in order to help you and your doctor decide what is the best form of treatment for you.
What are the risks associated with this procedure?
- There are some risks when you have general anesthesia, which should be discussed with your doctor.
- A local or regional anesthetic may not numb the area quite enough and you may feel some minor discomfort. Also, in rare cases, you may have an allergic reaction to the drug used in this type of anesthesia. Local or regional anesthesia is considered to be safer than general anesthesia.
- Some of the blood vessels in the lining of the uterus may leak.
- The uterus could be punctured and need surgery to repair it.
- There is a risk of infection and bleeding.
You should ask you doctor how these risks apply to you.
When should I call my doctor?
Call your doctor immediately if:
- you start to bleed again.
- you develop a fever.
- you have a lot of pain in your lower abdomen.
Call your doctor during office hours if:
- you have questions about the procedure or the results.
- you want to make another appointment
We offer a variety of services to help you and your partner achieve your goal of having a baby. The services we offer are:
- Hysteroscopy
- Laparoscopy
- Ovulation induction
- Timed inseminations
- Hormonal evaluation
- Semen analysis
- Post coital testing
- Hysterosalpingograms
- Endometrial biopsy
- Endometriosis treatment
One of the most important aspects of fertility is the production of progesterone (the second female hormone other than estrogen). This hormone is produced only after ovulation. Progesterone prepares the uterus to accept the fertilized egg. Furthermore, progesterone sustains the pregnancy inside the uterus until the fetus can maintain itself after 10-12 weeks of pregnancy. If you do not get pregnant during a cycle, the ovary stops making progesterone 14 days after ovulation and you have a period.
Progesterone is the hormone which causes the body's temperature to rise ½ to 1 degree at ovulation. Therefore if your Basal Body Temperature shows a sustained rise, then we have indirect evidence of ovulation and subsequent progesterone production.
A more direct method of evaluating progesterone production is with a blood test. We draw the blood test between days 21-23 of your cycle (determined by which of these three days is convenient for you to come to the office). Remember, on a perfect 28-day cycle, day 1 is the first day of your period, day 14 is when ovulation occurs and day 28 is the day prior to your next period. We will try to time the blood test on day 22 of the cycle. We actually do not send the blood until your next period occurs. In this way, we can be sure it was drawn on the correct day. Therefore, CALL THE OFFICE as soon as your period starts after having a progesterone level drawn.
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Mark the days on your actual calendar month with these instructions so you will be certain to follow them carefully. Call the office when your period starts.
Progesterone levels
- VERY IMPORTANT: you must keep a record of your menstrual cycles.
- Progesterone levels are drawn two ways:Progesterone levels will be drawn six days before your menstrual cycle begins. If you are not regular, this method cannot be used. Progesterone levels will be drawn day #22 after the first day of your menstrual cycle.
If menses do not begin 6-8 days after the progesterone level is drawn the level is inaccurate and must be repeated during the next cycle.