A hysteroscopy is a minimally invasive medical procedure used to examine the inside of the uterus using a thin, lighted tube called a hysteroscope. This scope is inserted through the vagina and cervix, allowing a doctor to directly visualize the uterine cavity. The procedure is used to diagnose and treat conditions interfering with natural conception. When operative hysteroscopy corrects these issues, the physical barrier to pregnancy is removed, significantly improving the prospect of natural conception.
How Hysteroscopy Prepares the Uterus for Pregnancy
The main purpose of operative hysteroscopy is to optimize the uterine environment where an embryo must implant and grow. Structural abnormalities inside the uterus can physically block implantation or disrupt blood flow to the uterine lining, the endometrium. By removing these growths or correcting structural issues, the procedure restores the cavity to a shape more receptive to pregnancy.
The removal of endometrial polyps and submucosal fibroids is a common therapeutic action performed during a hysteroscopy. These non-cancerous growths protrude into the uterine cavity, occupying space needed for embryo attachment. A hysteroscopic myomectomy, which removes a submucosal fibroid, eliminates this obstruction, making the uterine environment more hospitable for implantation.
Another common correction is the resection of a uterine septum, also called septoplasty. A septum is a congenital band of tissue that divides the uterine cavity, which can lead to recurrent miscarriages or implantation failure. Removing this tissue creates a single, unified cavity, improving the chances of carrying a pregnancy to term.
Hysteroscopy also treats intrauterine scar tissue, referred to as adhesions or Asherman’s Syndrome. These bands form after previous surgeries or infections and can cause the uterine walls to stick together, severely compromising the healthy endometrium required for pregnancy. Adhesiolysis is the process of precisely cutting and removing this scar tissue, helping the uterine lining regenerate and support an embryo.
The Post-Procedure Timeline for Trying to Conceive
Recovery after an operative hysteroscopy is generally fast because the procedure does not require external incisions. Most patients experience mild cramping and light spotting or bleeding for a few days to a week. Doctors advise a period of pelvic rest, avoiding intercourse, tampons, or douching for about one week. This prevents infection and allows the cervix to close.
The recommended waiting period before attempting conception allows the uterine lining to fully heal and regenerate. For a minor procedure like polyp removal, doctors suggest waiting until after the next full menstrual cycle. This waiting time, usually one to three months, ensures the endometrium is structurally sound and prepared for implantation.
If the procedure involved extensive treatment, such as removing a larger fibroid or repairing significant scar tissue, the doctor may recommend a longer waiting period of up to three months. Tracking the first post-operative period is important, as a normal menstrual flow suggests the uterine lining has successfully regenerated. Only after receiving medical clearance confirming the uterus has healed should a person begin trying to conceive.
Factors Affecting Your Natural Conception Rate
The likelihood of natural conception after a hysteroscopy depends heavily on the initial condition treated. Success rates are highly variable, reflecting the complexity of the underlying issue addressed. For instance, women who had polyps or small fibroids removed often see pregnancy rates in the range of 40% to 80% within a year.
Those who undergo surgery to correct a uterine septum or treat Asherman’s syndrome also have improved prospects. Pregnancy rates for septum resection are generally between 50% and 80%. Successful treatment of scar tissue can lead to conception rates as high as 60% to 90%. However, success with Asherman’s syndrome depends on the severity and extent of the scar tissue.
The hysteroscopy addresses only the structural health of the uterus, meaning non-uterine factors still influence the conception rate. Factors such as maternal age, ovarian reserve, fallopian tube patency, and male factor infertility remain relevant to natural conception. Younger age at the time of the procedure is consistently associated with a better chance of pregnancy.
If natural conception has not occurred within six to twelve months following the procedure, and other fertility factors are normal, consulting a specialist again may be necessary. The hysteroscopy optimizes the uterine environment, but if pregnancy is not achieved, the next step may involve exploring assisted reproductive technologies. The procedure increases the success rates of treatments like in vitro fertilization, even if natural conception is not achieved.