Medically reviewed by Dr. Shweta Agarwal, MBBS, DGO. Last updated: June 2026.
Information on this page is educational and does not replace a medical consultation. Individual findings and next steps depend on clinical factors.
Unlike an ultrasound, which views the uterus from outside, hysteroscopy allows the cavity to be seen directly — so subtle problems that affect fertility or cause abnormal bleeding can be identified and corrected precisely. In Marathi, this is sometimes described as गर्भाशय दुर्बिणी तपासणी (telescopic examination of the uterus). It is a core part of the complete fertility workup offered at Aansh Hospital & IVF Center, serving patients across Vidarbha and northern Telangana.
What is the difference between diagnostic and operative hysteroscopy?
Hysteroscopy is described in two forms depending on its purpose. Both use the same instrument; the difference is whether a problem is only viewed or also treated in the same sitting.
- Diagnostic hysteroscopy — used to look inside the uterine cavity to find the cause of a symptom (such as recurrent miscarriage, abnormal bleeding, or repeated IVF implantation failure). It confirms whether the cavity is healthy and normally shaped. A diagnostic hysteroscopy is short, often performed under local anaesthesia or mild sedation, and typically takes 10–20 minutes.
- Operative hysteroscopy — used to treat a problem found during the examination. Through fine instruments passed alongside the scope, the surgeon can remove a polyp, a submucous fibroid, or adhesions, or correct a uterine septum. Operative hysteroscopy generally requires sedation or short anaesthesia and takes 30–60 minutes depending on complexity.
In many cases, diagnosis and treatment happen in the same session — the abnormality is seen and addressed at once, avoiding a second procedure.
When is hysteroscopy used in fertility care?
Hysteroscopy is recommended when there is reason to believe the uterine cavity itself may be affecting fertility, implantation, or pregnancy — or when a uterine abnormality has been suggested by ultrasound or HSG. Common indications include:
- Recurrent implantation failure — when good-quality embryos have repeatedly failed to implant in IVF, hysteroscopy can detect subtle polyps, adhesions, or lining abnormalities that ultrasound may miss.
- Recurrent pregnancy loss — to check for a uterine septum, adhesions, or other structural causes of repeated miscarriage.
- Abnormal uterine bleeding — investigating heavy, prolonged, or irregular periods, or bleeding after menopause.
- Polyps and submucous fibroids — growths within the cavity that can interfere with implantation or cause bleeding can be removed.
- Intrauterine adhesions (Asherman's syndrome) — scar tissue, often from a past infection or uterine surgery, can be divided to restore a normal cavity.
- Uterine septum — a congenital dividing wall inside the uterus, associated with miscarriage, can be corrected (septum resection).
- Pre-IVF cavity assessment — confirming the cavity is clear and receptive before embryo transfer.
- A displaced or retained IUD — locating and removing a contraceptive device that has shifted.
Hysteroscopy assesses the inside of the uterus. When the outer surface of the uterus, the ovaries, or the fallopian tubes need to be evaluated or treated — for example in endometriosis or tubal disease — laparoscopy is used, and the two are sometimes combined in one operative session.
When in the menstrual cycle is hysteroscopy performed?
Hysteroscopy is usually scheduled in the follicular phase, typically between Day 6 and Day 12 of the cycle (after the period ends but before ovulation). This timing is chosen for two reasons:
- The uterine lining is at its thinnest in this phase, giving the clearest view of the cavity and any abnormality within it.
- There is no possibility of disturbing an early pregnancy, since the procedure is performed before ovulation.
If the procedure is being done to investigate abnormal bleeding, the timing may be adjusted on clinical judgement. The team will confirm your appointment date based on the first day of your last period.
How is hysteroscopy performed, step by step?
Hysteroscopy is a day-care procedure — no overnight admission is usually required.
Step 1 — Preparation Dr. Shweta Agarwal reviews your history and explains the procedure. If sedation or anaesthesia is planned, you will be asked to fast for a few hours beforehand.
Step 2 — Anaesthesia A diagnostic hysteroscopy may be done under local anaesthesia or mild sedation; an operative hysteroscopy is usually done under sedation or short general anaesthesia so you feel no pain. The appropriate option is discussed with you in advance.
Step 3 — Insertion of the hysteroscope The thin hysteroscope is passed gently through the vagina and cervix into the uterus — no incision is made. A clear fluid or gas is used to expand the cavity slightly so its walls can be seen clearly.
Step 4 — Examination (and treatment) The cavity is inspected on a monitor. If an abnormality is found and operative treatment was planned, fine instruments are passed alongside the scope to remove a polyp or fibroid, divide adhesions, or correct a septum in the same session.
Step 5 — Completion The scope is removed. The procedure typically takes 15–30 minutes (longer for complex operative work). You rest in the recovery area for one to two hours and are usually discharged the same day.
If sedation or anaesthesia is used, arrange for someone to accompany you home. Results and any next steps are discussed at a follow-up consultation.
What is recovery after hysteroscopy like?
Recovery from hysteroscopy is generally quick because there are no external cuts or stitches.
- Same day: mild cramping similar to period pain, and light spotting, are common for a day or so.
- Activity: most patients resume normal daily activity within a day after a diagnostic procedure; operative procedures may need a little more rest.
- After operative hysteroscopy (e.g. septum or adhesion removal): Dr. Shweta Agarwal may prescribe a short course of hormonal (oestrogen) therapy for a few weeks to help the lining heal smoothly over the treated area, and a brief follow-up hysteroscopy may be advised to confirm the cavity has healed before conception or embryo transfer.
Trying to conceive: after a diagnostic hysteroscopy, the next cycle is usually fine. After operative procedures, a wait of one to three months is commonly advised to allow the lining to heal fully. Dr. Shweta Agarwal will give a personalised timeline based on your procedure and recovery.
Contact the clinic promptly if you develop fever, heavy bleeding, or worsening pelvic pain after the procedure.
What are the risks of hysteroscopy?
Hysteroscopy is generally a safe procedure, and serious complications are uncommon. Known risks include:
- Mild cramping and spotting — expected for a day or two and not a complication.
- Infection (uncommon) — managed or prevented with antibiotics where indicated.
- Uterine perforation (rare) — a small risk of the instrument making an opening in the uterine wall, more relevant in complex operative cases.
- Fluid overload (rare) — related to the fluid used to distend the cavity during longer operative procedures; monitored throughout.
- Anaesthesia-related risks — where sedation or general anaesthesia is used, the standard small risks apply and are assessed beforehand.
The likelihood of complications is reduced by appropriate case selection, careful technique, and monitoring during the procedure.
How is hysteroscopy different from a D&C?
A D&C (dilatation and curettage) removes the uterine lining without direct visualisation — it is performed "blind." Hysteroscopy allows the surgeon to see the cavity and address a specific abnormality precisely, which reduces unnecessary disturbance of healthy tissue. For targeted problems such as a polyp, a submucous fibroid, or a septum, hysteroscopy is the more precise approach.
What is the cost of hysteroscopy?
Indicatively, hysteroscopy costs ₹20,000 – ₹25,000, though the exact cost varies depending on whether it is diagnostic or operative, the complexity of any treatment performed, and the type of anaesthesia used. At Aansh Hospital & IVF Center, the applicable cost is confirmed at consultation and can also be reviewed at the costs & EMI page, where financing options are explained. Final cost depends on individual clinical evaluation.
What happens after hysteroscopy?
Findings from hysteroscopy guide the next step in your care:
- Normal cavity: the uterus is confirmed receptive; attention turns to other factors in the fertility workup, and IVF or other treatment can proceed.
- Abnormality treated in the same session: a healing period (often one to three months) is advised before conception or IVF embryo transfer.
- Combined pathology: where both the cavity and the pelvis need attention, hysteroscopy may be combined with laparoscopy in a single operative session.
All findings are integrated into a personalised plan reviewed with you by Dr. Shweta Agarwal.