For hysteroscopy, a very narrow telescope is inserted into the uterus (womb) via the vagina and cervix. We use carbon dioxide gas or a liquid such as saline to distend the uterine cavity to give a clear view. The image is projected on to a television screen using a small video camera; you can watch if you like!

Hysteroscopy allows us to examine the endometrium (lining of the uterus), tubal ostia (small channels on either side which lead to the fallopian tubes), and assess the shape and size of the uterine cavity to make sure it is normal for pregnancy. The picture on the left shows a normal cavity, but we sometimes find polyps, fibroids, adhesions (scar tissue), septa (a midline division), or simply that the endometrium is unusually thickened. We can also inspect the canal of the cervix where we may find polyps. Sometimes, we take a small biopsy from the endometrium, but you should hardly feel it.

Diagnostic hysteroscopy does not take a long time and is not particularly uncomfortable. You can, however, have a local anaesthetic injection if you wish.

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