Hysteroscopy for IVF & Fertility

What Is a Hysteroscopy for Fertility?

A hysteroscopy for fertility is a procedure that lets your doctor see directly inside your uterine cavity. It’s a minimally invasive, in-office evaluation that identifies and corrects uterine conditions before your IVF cycle begins.

Felix Cohen, MD, FACOG and his team of experienced gynecologists perform a hysteroscopy for fertility at Hysteroscopy Center of New York in Midtown Manhattan, Columbus Circle and Queens. Affiliated with Mount Sinai, NYU Langone and Lenox Hill Hospital, Dr. Cohen builds his entire practice around uterine evaluation and treatment.

This practice uses advanced hysteroscopy technology and equipment, designed for in-office fertility evaluations. A Frontiers in Medicine study showed that women who have a hysteroscopy before IVF have improved odds of carrying a pregnancy to term. Women who skip it showed significantly lower rates of success.

Why Do I Need a Uterine Cavity Evaluation Before IVF?

Your uterine cavity holds your embryo, where it grows. Endometrial receptivity accounts for up to two-thirds of implantation failure, according to the American College of Obstetricians & Gynecologists (ACOG). Most patients never hear that statistic until after an unsuccessful cycle. The reasons Dr. Cohen recommends a uterine cavity evaluation for fertility patients in New York — and for women traveling from Canada — include:

• A history of one or more unsuccessful IVF cycles, where embryo quality isn’t the issue, pointing directly to a uterine environment problem
• Recurrent miscarriages that have gone unexplained despite standard fertility workups and genetic testing
• Abnormal findings on an ultrasound or hysterosalpingogram (HSG) that require visual confirmation and same-session treatment
• Unexplained infertility despite all other tests coming back normal
• Irregular or heavy abnormal uterine bleeding that signals an underlying uterine condition disrupting the endometrium

Your NYC gynecologist performs your evaluation in the New York office with no hospital stay and no general anesthesia needed. His see-and-treat approach means diagnosis and treatment happen in one appointment.

What Does Hysteroscopy Before IVF Find That Ultrasound Misses?

A hysteroscopy before IVF finds what ultrasound simply cannot see. Research shows minor intrauterine abnormalities exist in 20 to 45 percent of women whose scans appear completely normal. Conditions Dr. Cohen finds and treats include:

• Endometrial polypsThese small fleshy growths on your uterine wall sit exactly where your embryo needs to land. They’re present in up to 30 percent of women.
• Intrauterine adhesionsBands of scar tissue inside your uterus physically block the spots where your embryo needs to attach and grow.
• Uterine septumThis is a wall of tissue down the middle of your uterus where the blood supply is too weak to keep your embryo alive after it attaches.
• Submucosal fibroidsGrowths that push inward from your uterine wall change the shape of the space your embryo needs to settle into.
• Chronic endometritis. A low-level infection inside your uterus causes no symptoms, but may block your embryo from implanting every cycle.

A standard imaging report doesn’t catch these issues. Dr. Cohen finds and corrects them during one uterine cavity evaluation. Your uterus is then ready before your IVF cycle starts.

How Does a Hysteroscopy Before Embryo Transfer Improve My Results?

A hysteroscopy before embryo transfer finds and fixes the physical problems that stop your embryo from taking hold in your uterus. The procedure also gives your doctor a direct view of your uterine cavity, so your IVF team knows exactly where to place your embryo. Research in Reproductive BioMedicine Online reported that even women with a normal hysteroscopy result see improved IVF outcomes. Researchers attribute this to endometrial stimulation during the procedure itself.

“The embryo is only half the equation,” says Dr. Cohen. “The uterine environment is the other half. A hysteroscopy before embryo transfer makes sure that half isn’t working against you.”

For women in Canada traveling internationally, an office hysteroscopy at Hysteroscopy Center of New York is an appropriate first step. Dr. Cohen sends your fertility clinic a complete report of the findings and treatment, so your transfer is timed correctly.

What Should I Do if My IVF Produces No Results?

If your IVF produces no results, a hysteroscopy for IVF evaluation is the next logical step. Those cycles aren’t always about embryo quality. The uterine environment is the problem in more cases than fertility clinics admit. It goes undetected because nobody looks. Signs your cycle warrants a hysteroscopy for IVF evaluation include:

• Your fertility team grades your embryos as good quality every time, yet two or more transfers keep failing.
• A miscarriage follows a positive IVF result, especially when it happens early and more than once.
• Your ultrasound or sonohysterogram shows something off but nobody follows up by examining inside your uterus.
• Your fertility workup looks completely normal on paper, but a pregnancy still doesn’t happen.

“I see patients who’ve failed three or four IVF cycles, and nobody has looked inside their uterus,” says Dr. Cohen. “That’s always my first step.”

In women with two or more unsuccessful cycles, abnormal findings appear in 33 to 66 percent of hysteroscopy cases. This holds even when prior imaging looks completely normal.

What Happens After My Hysteroscopy for Fertility?

After your hysteroscopy for fertility, you go home the same day. Mild cramping and light spotting for a few days to two weeks are normal parts of your healing. You’re back to full activity within 24 hours.

Dr. Cohen schedules a post-procedure follow-up to confirm you’re healing properly and to give your IVF team the green light. PMC research shows that transferring embryos within 50 days of a normal finding produces the highest live birth rates. Where Dr. Cohen corrects a finding, one to three cycles give your endometrium time to heal.

For Canadian and international patients, Hysteroscopy Center of New York handles coordination between your care teams. Dr. Cohen sequences your hysteroscopy and embryo transfer correctly.

Why Should I Trust My IVF Preparation to Hysteroscopy Center of New York?

Dr. Cohen is a board-certified OB/GYN trained at Mount Sinai’s Icahn School of Medicine, where he earned recognition as Top Teaching Resident. He founded and directs Hysteroscopy Center of New York with one focus: to preserve your fertility health. The practice also offers Pro-Nox patient-controlled analgesia so you can manage procedural anxiety on your own terms.

Women across New York City and Canada choose Dr. Cohen because they want a gynecologist focused on uterine evaluation. The patient safety standards at Hysteroscopy Center of New York reflect that focus. Schedule your hysteroscopy for IVF consultation today at Hysteroscopy Center of New York in Midtown Manhattan, Columbus Circle or Queens.