1. What is Hysteroscopy?

Hysteroscopy is a procedure wherein the uterine cavity is explored under magnification using a hysteroscope.

2. For whom is it recommended?

It is done to diagnose problems inside the uterus and to treat certain conditions like uterine septum, polyp, adhesions.

3. How is it done?

A diagnostic hysteroscopy is an office procedure wherein a very thin scope is passed through the cervical canal to visualize the uterine cavity. An operative hysteroscopy is done under anaesthesia. It requires pre anaesthetic fitness, patient comes to hospital nil orally and procedure is carried out. Patient can be discharged a few hours later.

4. Is Hysteroscopy required for all patients prior to IVF/ICSI?

Routine hysteroscopy prior to IVF/ICSI is not recommended. It is done specifically in patients who fail to get a proper triple line endometrium with good vascularity before transfer. It is also done if a uterine septum, polyp, submucous fibroid or intrauterine adhesions are suspected on scan.

5. Are there any complications associated with Hysteroscopy?

Complications like uterine perforation, fluid overload and anaesthesia related are rarely seen with routine hysteroscopy.

6. Is admission in hospital required for hysteroscopy?

Hysteroscopy is an office procedure which doesn’t require any hospital admission. Patient reports to hospital empty stomach, consent is taken and procedure is performed. She is discharged a few hours later and can return to her routine activities thereof

ICSI is Intracytoplasmic Sperm Injection wherein the best sperm is selected from the sample and is injected into the egg retrieved.

They are different ways of getting the egg fertilized and which process is chosen over the other is individualized by the clinician for each couple

7. Are there any side effects associated with ICSI?

Presently used medications and the process of ICSI is extremely safe with no/minimal side effects

8. Is there a chance of twin/multiple pregnancy with ICSI?

In the era of elective single embryo transfer, the chances of twin/multiple pregnancy is nil. But of course, if more than 1 embryo is transferred then the chances of multiple pregnancy obviously increases

9. Is bed rest recommended after ICSI?

Bed rest is not recommended after ICSI.

10. What precautions need to be taken after embryo transfer?

Healthy, home cooked, protein and fibre rich food

Small, frequent meals, adequate amount of water

Stress free lifestyle, meditation can be practised

No bed rest

Intercourse need not be restricted

Travelling long distance may be avoided

Taking the stairs may be allowed

Positive attitude is most important

11. What are the reasons for failure of ICSI?

A good embryo and a receptive endometrium are the key to a successful IVF cycle

Failure at any point, the following should be considered:

Age of the couple

Number of eggs, morphology of the eggs

Sperm parameters

Number of embryos formed and the grade of embryos

Endometrial thickness and vascularity

Transfer technique

Despite everything being good, if a cycle fails, patience and persistence for a second attempt definitely helps