When ultrasound alone cannot explain why conception is not happening, hysteroscopy gives your specialist a direct, high-definition view inside the uterus. It is the gold standard for diagnosing and treating uterine conditions that can prevent implantation — and in many cases, the problem can be corrected during the same procedure.
What Is Hysteroscopy?
Hysteroscopy passes a thin, lighted telescope through the cervix to examine the uterine cavity in real time. It identifies abnormalities such as polyps, fibroids, adhesions, or septae — and can treat them in the same session. It is the gold standard for evaluating the uterus before fertility treatment.
When pathology is found during the diagnostic examination, operative instruments can be passed through the hysteroscope to remove polyps, divide adhesions, or correct a uterine septum without a separate procedure. This optimises the uterine environment for embryo implantation, particularly for patients with recurrent IVF failure or unexplained infertility.
Common Concerns Hysteroscopy Can Address
- Recurrent implantation failure after IVF embryo transfer
- Abnormal uterine findings on ultrasound such as polyps or fibroids
- Unexplained infertility where standard tests have not identified a cause
- Recurrent miscarriage with suspected uterine cause
- Abnormal uterine bleeding or irregular periods
Are You a Good Candidate?
- In good general health with no active pelvic infection
- Recommended for hysteroscopy by a fertility specialist or gynaecologist
- Able to attend a pre-procedure consultation and the procedure itself within a 3–5 day window
- Not currently pregnant
Techniques & Options
Hysteroscopy can be performed as a purely diagnostic investigation or as an operative procedure that treats abnormalities at the same time. Your specialist will recommend the appropriate approach based on your ultrasound findings, medical history, and fertility goals.
Both types are performed through the natural opening of the cervix — there are no incisions and no scars. The hysteroscope is connected to a camera that projects a magnified, high-definition image onto a monitor, allowing your specialist to examine every part of the uterine cavity in detail.
Diagnostic Hysteroscopy
A slender hysteroscope is gently passed through the cervix and into the uterine cavity. Sterile saline is used to gently expand the uterus, providing a clear view of the endometrial lining, the openings of the fallopian tubes, and the overall shape and structure of the cavity. The specialist inspects for polyps, fibroids, adhesions (Asherman syndrome), septae, and any other abnormalities. The entire examination typically takes 10–15 minutes.
- Direct visualisation is more accurate than ultrasound alone for detecting uterine pathology
- Can identify subtle adhesions and small polyps that imaging may miss
- Often performed under light sedation or even local anaesthesia for patient comfort
Operative Hysteroscopy
If an abnormality is identified — either during a diagnostic hysteroscopy or from prior imaging — operative instruments can be passed through the hysteroscope to treat the problem in the same session. Common operative procedures include polypectomy (removal of polyps), myomectomy (removal of submucosal fibroids), adhesiolysis (division of adhesions), and septoplasty (correction of a uterine septum). This avoid the need for a second procedure and allows faster progression to fertility treatment.
- Polyps and small fibroids can be removed in minutes with minimal bleeding
- Adhesion division can restore a normal uterine cavity and improve implantation rates
- Septum correction is associated with reduced miscarriage risk in subsequent pregnancies
Recovery Timeline
Day of Procedure
You'll arrive at the clinic having fasted as instructed. After a brief pre-procedure check, sedation or anaesthesia is administered and the hysteroscopy is performed. Most patients wake within minutes and rest at the clinic for 1–2 hours before being discharged. Mild cramping, similar to period pain, is normal and typically managed with over-the-counter painkillers.
Days 1–2 — Initial Recovery
Most patients feel well enough to move around comfortably the day after the procedure. Light spotting or watery discharge is normal and may continue for a few days. Avoid swimming, baths, and sexual intercourse for the time period advised by your specialist — usually around one week. Strenuous exercise should be avoided for a few days.
Day 3–5 — Follow-Up
A follow-up appointment is scheduled to review the hysteroscopy findings, discuss any pathology results if tissue was removed, and plan next steps for your fertility treatment. Your specialist will advise on the optimal timing to proceed with IVF or embryo transfer.
Returning Home
Most patients are comfortable to fly within 2–3 days of the procedure. You'll receive a detailed operative report and any pathology results, which can be shared with your fertility team at home. Your care coordinator will remain in contact to support your onward treatment plan.
What to Expect
Safety & Risks
Hysteroscopy is one of the safest gynaecological procedures, with serious complications occurring in fewer than 1% of cases. It is performed routinely in fertility clinics around the world. However, as with any procedure involving instrumentation of the uterus, there are risks you should understand.
- Uterine perforation (very rare, occurring in fewer than 1 in 1,000 cases)
- Infection of the uterus or surrounding structures
- Bleeding — usually mild and self-limiting, but occasionally requiring treatment
- Adverse reaction to sedation or anaesthesia
- Fluid overload from uterine distension media (rare, monitored throughout)
- Incomplete treatment requiring a follow-up procedure
Your specialist will discuss these risks with you before the procedure and take all necessary precautions. Hysteroscopy is performed under continuous visual guidance, meaning the specialist can see exactly what is happening at all times. Accredited Thai fertility clinics follow international safety standards, including real-time fluid balance monitoring and the use of modern bipolar energy systems that further reduce risk.
How Much Does Hysteroscopy Cost in Thailand?
Our pricing is transparent and all-inclusive — your quote covers everything from the initial consultation through to your follow-up appointment.
Hysteroscopy
All-inclusive hysteroscopy- Specialist consultation
- Pre-procedure assessment
- Hysteroscopy procedure
- Sedation or anaesthesia
- Follow-up appointment
- Dedicated care coordinator
Common Questions About Hysteroscopy
Everything you need to know before your procedure
Dr. Natthida Chaisiri
MEDICALLY REVIEWEDDr. Natthida Chaisiri
MEDICALLY REVIEWEDFertility Specialist · Bangkok
Last reviewed: February 18, 2026
Medical References
- AAGL — AAGL Practice Report: Practice Guidelines for the Diagnosis and Management of Endometrial Polyps
- ESHRE — Guideline on Recurrent Implantation Failure
- RCOG — Best Practice in Outpatient Hysteroscopy (Green-top Guideline No. 59)
- NHS — Hysteroscopy
- Di Spiezio Sardo A et al. — Role of Hysteroscopy in Evaluating Chronic Anovulation, Fertility and Sterility (2008)
What's Included
- Specialist consultation
- Pre-procedure assessment
- Hysteroscopy procedure
- Sedation or anaesthesia
- Follow-up appointment
- Dedicated care coordinator
Ready to Get Started?
Speak with our care coordinators for a free, no-obligation consultation and personalised quote.
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