Hysteroscopy for infertility: when it helps and what to expect

By Kanwar Nursing Home Info editors · Updated 4 November 2026

A hysteroscopy is a procedure to look inside the womb (uterus). A thin telescope with a light and camera, called a hysteroscope, is passed through the vagina and cervix, so no cut is needed. In fertility care, it is used to check the shape and lining of the womb, and to treat some problems that might make it harder for an embryo to implant or for a pregnancy to continue.

Hysteroscopy and laparoscopy are different

The two names sound alike and are sometimes done in the same session, but they look at different places:

Our laparoscopy guide covers the other procedure.

When a hysteroscopy may be suggested

A hysteroscopy is not a routine first test for every couple. The NICE fertility guideline in the UK advises that women should not be offered hysteroscopy as part of the initial investigation unless it is clinically indicated. Doctors are more likely to suggest it when:

• An ultrasound scan or dye test shows something unusual inside the womb, such as a polyp, a fibroid bulging into the cavity or an irregular shape.
• There is abnormal bleeding between periods or after sex.
• There have been repeated miscarriages.
• IVF has failed more than once despite good-quality embryos.
• There is a history of surgery or infection inside the womb that could have caused scar tissue (adhesions).
• A uterine septum, a band of tissue dividing the womb, is suspected.

What it can treat

When the doctor uses fine instruments through the hysteroscope, the procedure is called an operative hysteroscopy. It can be used to:

• Remove endometrial polyps.
• Remove fibroids that sit inside the womb cavity (submucous fibroids).
• Divide a uterine septum.
• Release adhesions inside the womb (as in Asherman's syndrome).
• Take a sample of the womb lining (biopsy) for testing.
• In some cases, open a blocked tube at the point where it joins the womb (tubal cannulation).

Whether a treatment improves the chance of pregnancy depends on the specific problem. Ask your doctor what the evidence shows for your situation.

How it is done

1. Simple diagnostic hysteroscopies are often done as an outpatient procedure, sometimes without anaesthesia or with a local anaesthetic. Operative hysteroscopies are more often done under sedation or general anaesthesia.
2. The hysteroscope is passed gently through the vagina and cervix.
3. Fluid is used to open up the womb so the doctor can see the lining clearly on a screen.
4. A diagnostic look usually takes 5 to 15 minutes; treatment takes longer.

It is usually planned for after your period has finished and before ovulation, and you may be asked to take a pregnancy test beforehand.

Recovery

• Period-like cramps and light bleeding for a few days are common.
• Most people go home the same day.
• Many return to normal activities within a day or two, depending on whether treatment was done and the type of anaesthesia.
• Your doctor may advise avoiding sex for a short time, to lower the risk of infection.

Risks

Hysteroscopy is generally a safe procedure. Uncommon risks include infection, heavy bleeding and, rarely, damage to the womb wall. Get medical help if you have a fever, severe pain that does not settle with simple painkillers, heavy bleeding or a smelly discharge afterwards.

Questions to ask

• What do you expect to find, and could it be treated during the same procedure?
• Will it be done in the outpatient clinic or in an operation theatre?
• What kind of pain relief or anaesthesia will I have?
• How will the result change my fertility plan?
• How long should we wait before trying to conceive, or before an embryo transfer?

If you are starting treatment at a fertility clinic, it is also worth reading our explainer on the ART Act 2021, which sets the rules clinics in India must follow.

How the results are used

After a diagnostic hysteroscopy, your doctor will usually explain what was seen straight away, and give you a written report. If a biopsy was taken, the laboratory result may take a few days. The findings help decide the next step: trying naturally for a while, treating a problem with an operative hysteroscopy, moving on to IUI or IVF, or adjusting an IVF plan. Keep the report and any photos with your fertility records, as other specialists may ask for them later.