# Advice please: should I have a hysteroscopy before IVF?



## Kaur_33 (Apr 17, 2014)

Hi everyone, I'm new to IVF and just started my treatment (follicular protocol), the clinic have given me an option of having a "hysteroscopy", it's very expensive (£1600) and the clinic said its up to me whether to have it or not. Can anyone please advise me on your opinions of it? Thank you, I've driven myself crazy researching on it, have no idea if it is worth it or not.


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## Gwiazda (Aug 7, 2014)

Hi Kaur_33
I had a hysteroscopy done before starting Ivf (after two failed iuis). I wasn't given a choice about it -well I guess I could have refused, but our doctor wanted to rule out any problems before beginning ivf and it seemed like the way to go. 

It wasn't a procedure that I enjoyed - general anaesthetic and bleeding afterwards but I was back at work the next day so I guess it wasn't that bad. We had to pay but we live abroad and I think it was about £250, so maybe having it done abroad would cut the cost if you decide to go for it.


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## CrazyHorse (May 8, 2014)

Do you have any spotting during your cycle (i.e., bleeding outside your menstrual period) or any findings on ultrasound or other imaging studies which indicate uterine polyps or other malformations inside the uterus? Do you have a history of recurrent miscarriage, uterine surgery, or abnormal endometrial biopsies? If the answer to all of the above questions is "no", I would skip the hysteroscopy, as it is not a risk-free procedure. 

However, if you have a history that suggests you might have scar tissue, adhesions, polyps, or inflammation in the uterus, or a history of multiple unexplained miscarriages, then it may be worth doing. I really don't think doctors should recommend hysteroscopy as a default pre-IVF procedure in the absence of indications that it is genuinely needed, as there are small risks of infection and uterine perforation. 

Best of luck with your decision!


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## HillBill (Nov 16, 2012)

Hi there, yes I have had one. I have severe endo & have had 2 ivf cycles which both failed, I then moved to the Lister who recommended I had one as well as a laparoscopy.  Yes it's expensive but if your consultant thinks it's worth doing I would take his advice. I had mine before my 3rd cycle. My only regret is going straight into ivf right after. I had the op in March and then 2 weeks later started on the drugs. Docs said this would be fine but I had my worse cycle ever (had to cancel due to lack of response to drugs). Don't know if it's related but looking back I should have left my "internals" rest for a few months. If your consultant says it may help with your ivf treatment I think it's definetly worth having it done. Good luck!


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## Itsallokay (Aug 10, 2014)

I haven't had one of these done and I'm due to start the ivf process at the end of August. My consultant said that bc I'm going straight to ivf and by-passing the Fallopian tubes that it wasn't a requirement. I can't help think that maybe I should have gotten it done. Just to be sure, you know what I mean. I'll reconsider it again, pending the results of this ivf. (Interesting comment from *pas* below on waiting time between lap and ivf start date)
It really depends on your stats and personal history. The hardest part about TTC is making all these really tough decisions, you have got to follow your instinct. 
Good luck with it.


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## duckybun (Feb 14, 2012)

Hi,

I cycled with the argc earlier this year and had the hysteroscopy. As far as I can remember its a slightly different procedure from other clinics hysteroscopy. The way they explained it to me was that it was to map out te uterus so they know where the best place to put the embryos back in is and also thy perform implantation cuts while they're there to help the embies implant. This is part of the reason the argc like to do it right before you cycle. If they find anything that needs treated them I guess it changes their plan of action but they really so it to have a look, check all is ok and give you the implantation cuts. It is very expensive but getting it done elsewhere would mean they don't have the measurements of your uterus for transfer so may be a bit pointless unless you are expecting it to be surgical and have scar tissue that needs removing. Ww mr ahead with it as we just thought we went with the argc to have everything thrown at it so in for a penny in for a pound. I also had the follicular protocol so if you have any questions feel free to ask away... Btw that cycle worke a treat for us and I'm now 29 weeks pg with twins after years of trying 

X
Ducky


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## duckybun (Feb 14, 2012)

Sorry for typos on the phone!


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## agate (Nov 14, 2008)

because you got pregnant easily and haven't since, imho it makes sense for you to check the uterus somehow just in case the reason you aren't pregnant is purely down to a scarring from the miscarriage and you don't actually need IVF at all.  So if it was me I'd at least want a good saline contrast hysterogram (aquascan) if not a full hysteroscopy.  it would be good value for money if you found the problem is uterine and could find yourself pregnant again naturally


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## CrazyHorse (May 8, 2014)

That's true -- if you had an ERPC or D&C, that could cause scar tissue. That *would* be an indication for a hysteroscopy, esp. if there's not other obvious reasons for infertility. Did your consultant have a strong opinion on whether a hysteroscopy was actually advisable, or was it more a matter of "whatever you're more comfortable with"?


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## Itsallokay (Aug 10, 2014)

Oops sorry I totally mis-read the context of this post and my reply was totally not necessary! Apologies. Xox


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## Kaur_33 (Apr 17, 2014)

Thank you everyone for the helpful responses. Sorry I haven't replied earlier. I think I will go for it. Ducky congrats on your pregnancy! I'm feeling more positive about it, I will definitely ask you questions once my process starts as at the moment they've given me suprefact which I take for a few more days - is that what you took?

Thanks again everyone for the responses xx


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