A uterine cavity evaluation is an important part of the workup for anyone looking to get pregnant in the near future (for those interested in freezing eggs or embryos for later use, this part of the evaluation can often be deferred).
The evaluation can be done via different methods, all of which aim to evaluate the endometrial cavity—the inside of the uterus, where an embryo will implant. The goal of the assessment is to identify if there is anything within the cavity that could inhibit or disrupt a potential embryo from implanting, such as polyps, fibroids, scar tissue, or a uterine septum. In the majority of cases, most who are identified to have one or more of these conditions had no symptoms or issues previously.
Tests typically used include a hysterosalpingogram (HSG), a sonohysterogram (SHG), or a hysteroscopy. All are different methods that involve filling the uterine cavity with fluid, causing the uterus to expand, which allows for a clear view of the contours of the uterine walls within the endometrial cavity to assess if any “cavity-filling defects” are present.
Depending on the location and size, and whether it is a polyp, fibroid, septum, or scarring, removal of it prior to proceeding with pregnancy is commonly recommended. The majority of these can be removed with outpatient procedures such as a hysteroscopy. However, depending on the situation, some might require more involved procedures.
An informed discussion following your uterine cavity evaluation is key to understanding if and what was seen during the test and if this has any effect on the next steps in your fertility journey.
