Hysteroscopy name is derived from two Greek words - “Hystera” meaning womb or uterus and “scope” meaning to see. Providing the best Hysteroscopy treatment in Delhi, Hysteroscopy is nothing but putting a telescope inside the uterus and seeing the cavity. There is no cut given anywhere on the skin.
The high resolution camera attached to the endoscope projects on a big television so the vision is crystal clear and enlarged. Although today Hysteroscopy can be used operatively as well - this can be done by inserting special instruments like scissors or forceps by way of another channel in the telescope. Hysteroscopy has proved to be a blessing to childless couples as most of the intra-uterine defects can be corrected by way of Hysteroscopic surgery.
If no intervention is required after visualising the uterus (i.e. when everything is normal) we call it - “Diagnostic Hysteroscopy”. And when there are intrauterine lesions like fibroids, polyps, adhesions, defects, etc that are corrected, it is called “Operative Hysteroscopy”. If something wrong is found during Diagnostic Hysteroscopy we don’t need to perform another surgery - we can do the operative intervention in the same sitting. Previously done commonly, today Diagnostic Hysteroscopy is done only in selected cases as the High resolution Ultrasound machines diagnose most of the uterine defects accurately.
“Office Hysteroscopy” is basically doing Hysteroscopy employing thin (Versascope or Bettochi office hysteroscope) instruments so that we don’t need anaesthesia. It is like an OPD procedure done when the patient is fully awake. So it is also called Office Hysteroscopy and it takes only 5 minutes or so.
Many studies have demonstrated increased chances of conception after an IVF or ICSI cycle after hysteroscopy / Fertility enhancing surgery.
Hysteroscopy today has become indispensable in any IVF Clinic. Being the best IVF clinic in Delhi-Ncr, without hysteroscopy some of the most basic and common defects like uterine polyps or septum cannot be corrected. These defects play a major role in not just brining infertility but also failing an IVF cycle by preventing the embryos to implant. By correcting or removing these defects, essentially, we are restoring the fertility.
Hysteroscopy is generally advised if you have complaints like irregular and increased menstrual bleeding, bleeding in-between periods, post-menopausal bleeding, infertility, repeated miscarriages, Ultrasound appearance of a uterine lesion like polyp/Fibroid, previous difficult embryo transfer, or when your periods are erratic or stopped altogether.
1. Sub-mucosal Intra-uterine fibroids
Fibroids are benign muscular growths that do not let an embryo implant to the endometrium by pressure effects or altered blood supply. Hysteroscopy is an effective tool to get rid of the fibroid by detaching it from its base. Surgically speaking the grade - 0 and grade - 1 fibroids are those that benefit most from Hysteroscopy and they are also the ones that cause most infertility.
2. Uterine polypss
Polyps are soft tissue out-growths that resemble the endometrium. Left untreated, polyps can reach large sizes and can cause abnormal bleeding, infertility and discomfort to the patient. Polyps are effectively tackled by Hysteroscopic surgery. With hysteroscopy we have an added advantage of direct visualisation and also making sure the rest of the cavity is normal.
3. To evaluate the uterus after previous failed IVF and Repeated Miscarriages
If you’ve had one or more IVF/ICSI attempts and failed a Hysteroscopy can help to evaluate the uterine cavity in utmost detail. Along with evaluation we can also perform endometrial scratch therapy in the same sitting and this scratch therapy has been found to help in improving the chances of conception in future cycle. Again, patients with repeated miscarriages should undergo Hysteroscopic uterine evaluation to rule out anatomical cause of Repeated Pregnancy Loss.
4. Intrauterine Adhesions or Asherman Syndrome
Due to conditions like infections, previous curettage procedure, Tuberculosis, chronic endometritis, etc. sometimes the uterine walls stick to each other. There is formation of band like fibrous scars, medically called “Adhesions”. These adhesions would not let the uterine cavity distend for successful implantation - leading to Infertility. Indeed, the adhesions in some cases are so severe that the patient does not even get her menstrual periods - leading to Amenorrhea.
By way of Hysteroscopic surgery, we insert tiny scissors through a separate channel in the operating telescope. Under direct vision, the scissors will slowly cut all the adhesion bands and ‘release’ the uterus from them. Essentially the procedure can be finished in just one sitting by experienced operators. Having performed more than 5000 Hysteroscopic surgeries, Dr Dalal is one of the most experienced Hysteroscopic surgeons in the country.
5. Uterine septum
Uterine septum is an abnormal fibrous tissue which hangs like a curtain in the middle of the uterus vertically and divides the cavity into two smaller ones. Septum can make the uterus irritable and prevents the embryo to implant the normal way. This condition, therefore, not only causes Infertility but when conceived, the septum can cause miscarriages as well. Therefore it is important to remove the septum and the best way of doing that is through Hysteroscopy.
6. Miscellaneous conditions like Abnormal Uterine Bleeding, Contraceptive removal, Metroplasty, etc.
Abnormal bleeding - either in pattern or amount of blood may indicate an underlying uterine cause like polyps or fibroid which can be tackled with hysteroscopy. Sometimes there is a retained Cu-T contraceptive device inside that can be removed with Hysteroscopy if there is a difficulty in removing it by usual method.
Hysteroscopy is a very safe procedure. Complications are rare and seldom serious. Mild, manageable effects like spotting or irregular bleeding, abdominal cramps, white discharge from vagina, etc sometime occur but they can be managed.
Please go through the following links of Publications done by Dr Dalal in International Journals.
https://www.jaypeejournals.com/doi/pdf/10.5005/jp-journals-10016-1012Role of Hysteroscopy prior to Assisted Reproductive Techniques in patients with previous IVFfailures -International Journal of Infertility & Fetal Medicine, Jan-April 2011
http://www.reproductivemedicine.com/toc/auto_abstract.php?id=23923Hysteroscopic Metroplasty in Women with Primary Infertility and Septate Uterus: Reproductive Performance after Surgery. Journal of Reproductive Medicine (A reputed American Journal). The PUBMED link of the same publications can be viewed here -
http://www.ncbi.nlm.nih.gov/pubmed/22324262.Dr. Dalal has received numerous awards for this very publication.
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