Key Takeaways

• Hysteroscopy is the gold-standard procedure to diagnose and treat uterine adhesions and septum.
• Adhesions can block the uterine cavity, impair implantation, and cause miscarriage.
• A uterine septum is a congenital tissue divide that increases early pregnancy loss.
• Treatment through hysteroscopic surgery can significantly improve fertility outcomes.
• Recovery is quick, usually within 24–72 hours, with long-term benefits for IVF and FET cycles.

Many individuals struggling with infertility later discover that the issue lies not with hormones or egg quality but with the uterine cavity itself. Two of the most commonly overlooked structural issues are uterine adhesions and a uterine septum. These can disrupt implantation, cause miscarriages, and interfere with embryo development.

Fortunately, hysteroscopy—a minimally invasive, camera-guided procedure—offers both diagnosis and treatment in a single session. This blog covers the basics of hysteroscopy, why adhesions and septum form, how surgery helps, and what intended parents should expect during recovery.

Understanding Uterine Adhesions and Septum

What Are Uterine Adhesions?

Adhesions are internal scar tissues inside the uterus. They can partially or fully block the cavity, a condition often known as Asherman’s Syndrome.
Common causes include:

• Previous D&C procedures
• Post-delivery complications
• Infections
• Uterine surgeries

Symptoms may include light periods, infertility, or recurrent miscarriage.

What Is a Uterine Septum?

A uterine septum is a congenital (birth-related) band of tissue dividing the uterus into two chambers.
It can:

• Reduce blood flow to the implantation area
• Increase miscarriage risk
• Cause recurrent implantation failure
• Disrupt embryo development

Hysteroscopy allows precise removal of the septum without external incisions.

What Is Hysteroscopy and Why Is It Used?

Hysteroscopy uses a thin telescope with a camera to visualize the uterus. It helps doctors:

• Diagnose structural problems
• Remove adhesions
• Resect the uterine septum
• Improve the uterine cavity before IVF or FET

The procedure is usually done under mild anesthesia and lasts 15–30 minutes.

Types of Hysteroscopy Procedures

1. Diagnostic Hysteroscopy

Used to inspect the uterine cavity and identify abnormalities.

2. Operative Hysteroscopy

Used to correct issues such as:

• Adhesions
• Septum
• Polyps
• Fibroids (small submucous)

Most fertility-related corrections are performed through operative hysteroscopy.

Benefits of Treating Adhesions and Septum Before IVF/FET

• Restores normal uterine anatomy
• Improves blood flow to endometrium
• Increases implantation rates
• Reduces miscarriage risk
• Enhances embryo survival
• Creates ideal conditions for a future FET

Recovery After Hysteroscopy

Expected recovery timeline:

• 0–24 hours: Mild cramping, light spotting
• 24–72 hours: Most patients return to normal activities
• 1–2 weeks: Full uterine healing begins
• 4–8 weeks: Follow-up scan before next cycle or FET

Doctors may prescribe estrogen or antibiotics depending on the repair performed.

Case Study

Case: 34-year-old with repeated implantation failure
A patient undergoing multiple IVF cycles had no success despite high-quality embryos. A diagnostic hysteroscopy revealed moderate adhesions covering one side of the uterine cavity. She underwent operative adhesiolysis.
Outcome:
Two months later, a Frozen Embryo Transfer resulted in a viable pregnancy.
Lesson:
Correcting structural issues can dramatically improve outcomes, even when embryo quality is excellent.

Testimonials

1. Meera, 32

“After two miscarriages, hysteroscopy showed I had a septum. Once removed, my next FET worked. I wish I’d known earlier.”

2. Riya & Aaron, 36

“The procedure was quick and recovery was easy. Our doctor said removing adhesions would help—and it truly did.”

3. Sahana, 29

“I was afraid of surgery, but hysteroscopy changed everything. My periods normalized and we finally conceived.”

Expert Quote

“Correcting adhesions or a uterine septum before IVF significantly boosts implantation and reduces miscarriage. Hysteroscopy is one of the most powerful tools we have to improve fertility outcomes.”
— Fertility Surgeon, Minimally Invasive Gynecology

Related Links

• Pillar: Complete Guide to IVF & Uterine Health
• Understanding FET Preparation
• Why the Uterine Lining Matters
• Surgical Options Before Fertility Treatment
• Managing Recurrent Implantation Failure

Glossary

• Adhesions: Scar tissues inside the uterus.
• Septum: Congenital tissue dividing the uterus.
• Hysteroscopy: Camera-based procedure to evaluate and treat the uterus.
• Asherman’s Syndrome: Severe adhesions causing infertility.
• Resection: Surgical removal of abnormal tissue.
• Operative Hysteroscopy: Hysteroscopy used for treatment, not just diagnosis.

FAQs

Q. What symptoms suggest I may have adhesions or a septum?

Ans : Symptoms may include light periods, irregular cycles, infertility, recurrent miscarriage, or difficulty with embryo implantation. Some individuals have no symptoms and discover the issue only through hysteroscopy.

Q. How is hysteroscopy performed?

Ans : A small camera is inserted through the cervix to visualize the uterus. Fluid expands the cavity, allowing clear viewing. If needed, surgical tools are passed through the scope to correct issues. No abdominal incisions are made.

Q. Is hysteroscopy painful?

Ans : Most procedures use mild anesthesia or sedation. Patients usually feel little to no discomfort, and recovery is quick with minimal cramping.

Q. How long is recovery after adhesions or septum removal?

Ans : Light spotting and cramping may last 48–72 hours. Full internal healing takes 4–8 weeks, after which IVF or FET can resume.

Q. Can adhesions return after surgery?

Ans : Mild adhesions rarely return. Severe cases may recur, but doctors often use estrogen therapy or balloon placement to prevent reformation.

Q. Does a uterine septum always need removal?

Ans : Not always, but most septums are associated with pregnancy complications. Removal is often recommended when planning IVF or if there is a history of miscarriage.

Q. How soon after hysteroscopy can I try for pregnancy or FET?

Ans : Most specialists recommend waiting 1–2 menstrual cycles, depending on the procedure and healing assessment.

Q. Is hysteroscopy safer than laparoscopic surgery?

Ans : Yes. Hysteroscopy is less invasive, has no external cuts, and offers faster recovery compared to abdominal surgery.

Q. What tests might be needed before hysteroscopy?

Ans : Ultrasound, saline sonography (SIS), and sometimes MRI. These help map the cavity but hysteroscopy provides the clearest visualization.

Q. Can hysteroscopy improve IVF success rates?

Ans : Absolutely. Correcting adhesions, septum, or abnormal tissues significantly increases implantation and reduces miscarriage risk.

Q. What causes uterine adhesions to form?

Ans : The most common causes are surgical procedures like D&C, infections, postpartum complications, or previous uterine operations.

Q. Are there risks with hysteroscopy?

Ans : Risks are minimal and include mild cramping, spotting, small chance of fluid imbalance, or very rare perforation. Overall, it is considered one of the safest fertility procedures.

Preparing for IVF or FET?
Ensure your uterine cavity is ready. Learn more and book expert consultation at www.surrogacy.com.