Fertility Hysteroscopy

Women with abnormalities inside their uterine cavity may suffer from a variety of problems including infertility, pain and bleeding. Fertility hysteroscopy is a surgical procedure that allows a physician to see inside the uterine cavity to diagnose and correct these problems. Hysteroscopy is also used in certain circumstances to remove see or remove tissue while a woman is pregnant.

The hysteroscope is a thin, fiber optic telescope. It is approximately the size of one of your fingers. The fiber optics allow light to be brought into the uterine cavity. Saline (salt water) is pumped into the uterine cavity to push the walls of the uterus apart making it easier for the physician to see inside.

The night before fertility hysteroscopy

It is extremely important that do not eat or drink anything after 7:00 p.m. the night before surgery. Do not smoke or chew gum. It is okay to brush your teeth but do not swallow water. If you are currently taking medication, ask you doctor if you should stop taking it.

Check with your doctor to see if medication should be taken the night before the surgery in order to lessen the risk of blood clots forming during the surgery.

Nail polish, make-up and jewelry should be removed the night before surgery. Wear loose-fitting clothes.

Immediately before fertility hysteroscopy

Please arrive at Naperville Fertility Center one hour before your procedure. After you check in at the Naperville Fertility Center front desk, you will be taken to a private admit / recovery room. You will be asked to remove all of your clothing (including underwear) and put on a patient gown. The nurse will complete a medical history and you will be asked to sign consent forms. One of our board certified anesthesiologists will also review your medical history and will then place an intravenous (IV) line in your arm. At this point, there is nothing but saline going into your veins, but later, the anesthesiologist will use this to administer medications to you.

Immediately prior to surgery, you will be asked to empty your bladder. Glasses, contact lenses, and jewelry (including piercings) should be removed. NFC has installed a locker in each admit / recovery room. Your valuables can be locked up and you can take the key with you or given to the person who accompanied you.

In the Operating Room

For fertility hysteroscopy procedures, you will be taken to the operating room on a cart (essentially a bed on wheels). You will be asked to slide over to the cushioned operating room table. At this point, everyone in the operating room will be asked to stop what they are doing and perform a time-out. During the time-out, you will be asked to say your first and last name, date of birth, type of surgery you are having and confirm whether or not you have any allergies. Then, various members of the operating room staff will complete a checklist to make sure that all of the equipment for the surgery is present and working, medications to be used are identified and labeled correctly. At the conclusion, the anesthesiologist will administer the medication to allow you to drift off to sleep.

After fertility hysteroscopy

After surgery, you will wake up in the same room that you were first admitted to prior to the surgery. You will be connected to monitors that allow the recovery room nursing staff to check your blood pressure, pulse and temperature frequently. The anesthesia medication will cause you to have limited short term memory. This means that you may not remember things you said or heard even a few minutes before. This is normal and will last only a short time.

There are different phases of recovery after fertility hysteroscopy. In phase 1, the staff is making sure that you are stable and not having any problems after the surgery. You will not be allowed to have visitors in phase 1. In phase 2, you may have visitors and will be given something to eat and drink.

Your physician will discuss the findings with your family immediately after the surgical procedure is complete. The surgeon will have high resolution digital images to view on a tablet.

Medication will be available for pain or nausea. Medications will initially be administered though the IV until you are able to drink. Once you are able to drink, you can take oral medications.

You may notice a sore throat after the fertility hysteroscopy. This is caused by irritation from the breathing tube placed in your throat (trachea) during anesthesia. It usually lasts for just a few days and can sometimes be helped by throat lozenges.

You will remain in the recovery area at NFC until you are determined stable and able to be discharged. For most patients, you can expect to stay in the recovery area for one to two hours. The nursing staff will be evaluating your

• vital signs to make sure you are stable
• ability to empty your bladder
• ability to tolerate eating and drinking without experiencing nausea or vomitting

Once you can demonstrate all of these things, you will be allowed to go home. You will be given prescription pain medication and nausea medication to take at home. Most women, however, find that they do not need to take the prescription medication. You may take over the counter pain medications such as ibuprofen or acetaminophen.

After Surgery Care and Follow up

Pain and bleeding

Some women may experience some cramping after a fertility hysteroscopy. Most women indicate that the cramping is similar to or less than the cramping they have from their periods. It is common for women to experience vaginal spotting or bleeding after a fertility hysteroscopy. Again, this is usually similar to or less than the bleeding from a period. If you experience heavy bleeding, such as soaking two or three pads an hour for several hours in a row, this is not normal. You should call your doctor’s office.

Diet

Unless you are told otherwise, you may eat or drink anything you like. Some patients will experience nausea from the anesthesia medications. If you do experience nausea which is not remedied by the prescription medication you were given, please call your doctor’s office and speak either with the physician or with the nurse.

Activity

For the first 24 hours after your fertility hysteroscopy, you should just rest at home. You should not drive or operate machinery. You may increase your activity gradually after the first 24 hours. Most patients find that by the next day, they can resume most if not all of their normal activities.

Urination

During fertility hysteroscopy, a catheter is placed into your bladder to allow your urine to be emptied during the surgery. The catheter is usually removed before you wake up in the recovery room. It is common to experience some discomfort when urinating for the first day or two after surgery. If you experience burning or pain with urination after the first few days, or if you also have a fever, it is possible you might have a bladder infection. Please call your doctor to report these symptoms right away.

Infection

If you feel like you have a fever, please take your temperature. Notify your doctor’s office if your temperature is 101 degrees or higher.

Sexual Activity

Sexual activity may be resumed after your vaginal bleeding has stopped.

Postop appointment

One day after the surgery will you receive a phone call from the nursing staff to make sure you are doing okay. At that time, you should set up an appointment to return to the doctor’s office for a postop visit and exam.