Women with a history of recurrent pregnancy loss, infertility or abnormal uterine bleeding may be evaluated using Hysteroscopy. Diagnostic hysteroscopy is helpful in the examination of the uterine cavity (Figure 3). It is very useful in the diagnosis of abnormal uterine conditions such as fibroids, polyps, scarring or congenital malformations. In order to evaluate the uterus prior to hysteroscopy, an x-ray of the uterus along with the fallopian tubes (hysterosalpingogram) or sonohysterogram which is an ultrasound done by introducing saline into the cavity of the uterus or an endometrial biopsy may be performed.

In diagnostic hysteroscopy, usually the first step involves stretching the canal of the cervix slightly with a series of dilators. This helps to increase the size of the opening temporarily. On dilation, a thin,long, lighted, instrument like a telescope known as hysteroscope is inserted into the uterus through the cervix. Hysteroscopy does not require skin incisions to be made. Using the hysteroscope special fluids or carbon dioxide gas is injected into the uterus. This is done to get a clear picture of the uterus as the gas or fluid expands the cavity of the uterus and provides a good view of the uterus interiors. This is performed as an outpatient procedure in a physicians office. It is often performed soon after the menstrual cycle is over since the evaluation of uterine cavity is easier.