Classical hysteroscopy
Hysteroscopy is visualization of the endometrial cavity with a lightened telescope. It can be performed for either diagnostic or therapeutic purposes. Therapeutic hysteroscopy is performed under general anesthesia and cervical dilatation is required.
Routine diagnostic hysteroscopy before IVF is a subject of debate. But, it is not advised actually.
An electroresector is used for septum resection or endometrial polyp or myom excision. Also, intrauterine adhesions may be dissected via the electroresector. Endometrial ablation may be performed for patients who have persistent menometrorrhagia and who do not deisre any more children.
Office hysteroscopy
This is the type of hysteroscopy performed in the office without general anesthesia. Office hysteroscope is very thin and the procedure does not require cervical dilatation. Although it was used mainly for diagnostic purposes, its therapeutic use initiated during last years. It is used for abnormal uterine bleeding, assessment of infertility, intrauterine adhesions or polyp resection. Septum resection is also possible with office hysteroscopy. Office hysteroscopy is also useful for dislocated intrauterine devices.
Office hysteroscopy is also useful for premenopausal or postmenopausal uterine bleeding. Polyps, myoma uteri or malignancies may be diagnosed by office hysteroscopy.
Space occupying lesions of the endometrial cavity may lead to infertility. Thus, office hysteroscopy is a useful tool for the management of infertility. It is even more important for couples with a previous unsuccessful IVF attempt. Office hysteroscopy reveals anomalies in up to 50% of patients with a previous unsuccessful IVF attempt. Treatment of these anomalies increase success rates of following attempts.
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