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What is a Uterine Cavity Evaluation?

A textbook image of the female reproductive system being looked down upon by a person with light hair

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.

Author
Nidhee Sachdev, MD, FAOCG Dr. Nidhee Sachdev Nidhee Sachdev, MD has trained among the most prestigious and diverse medical programs in the country, including fellowship training in reproductive endocrinology and infertility at the prestigious New York University (NYU) Langone Fertility Center in New York City where she conducted research on preimplantation genetic screening (PGS) and the University of Chicago Medical Center, where she earned the academic distinction of chief resident in obstetrics and gynecology, and trained under a top recurrent pregnancy loss expert. Dr. Sachdev is passionate about providing individualized, collaborative patient care. She started her medical career right here in Orange County, earning her Doctor of Medicine at the University of California, Irvine, School of Medicine.

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