Why might hysteroscopy be offered before pregnancy?

What does the evidence say about hysteroscopy before pregnancy?

1. A hysteroscope shows the cavity directly, unlike an ultrasound image of the uterus. An examination to look for an explanation and an operation to remove tissue are different purposes. Ask whether the booking covers inspection alone or includes another procedure if a finding is seen. 1
2. Hysteroscopy can address selected polyps, fibroids, or scar tissue inside the cavity and can obtain a biopsy. It does not mean all uterine or pelvic conditions are visible through the camera. Ask what the suspected finding is and how the result would affect pregnancy planning. 2
3. A saline sonogram may provide useful cavity information without direct camera inspection. The appropriate next test depends on what earlier imaging showed and whether tissue sampling or removal is needed. Clarify why hysteroscopy is being proposed rather than assuming the most invasive test always supplies the best answer. 3
4. ASRM recommends a directed fertility evaluation based on history and findings. A cavity procedure does not replace assessment of ovulation, the tubes, or sperm when relevant. Ask where hysteroscopy fits within the full evaluation and which other questions remain open. 4
5. Pain relief should be discussed when the procedure is first proposed. Available options vary by the setting, planned procedure, and individual needs. Tell the clinician about previous painful examinations or concerns, and ask about recovery instructions and transport if sedation or general anesthesia is planned. 2

What decisions belong before and after hysteroscopy?

• Before booking, clarify whether the goal is inspection, sampling, or removal.
• Before the procedure, agree on pain relief, pregnancy precautions, and transport needs.
• Afterward, obtain results and a specific plan for recovery and pregnancy attempts.

Questions for your fertility or prenatal team