Hysteroscopy (Diagnostic)

By RRM Academy Reviewed by Dr. Naomi Whittaker, MD, Board-Certified OBGYN, MIGS, NFPMC, FCI Updated May 14, 2026

Diagnostic hysteroscopy is the direct endoscopic visualization of the uterine cavity and cervical canal using a thin, illuminated camera introduced through the cervix, without incision. It provides a real-time view of the endometrium and uterine walls that no imaging test fully replicates. Major professional society guidelines recognize diagnostic hysteroscopy as the definitive standard for evaluation of intrauterine pathology.¹²

The procedure identifies endometrial polyps, submucosal fibroids, intrauterine adhesions consistent with Asherman syndrome, uterine septa, and an isthmocele (cesarean scar defect). Each of these findings carries implications for fertility and pregnancy outcomes. In premenopausal women with regular cycles, timing the procedure in the early follicular phase, after menstruation and before ovulation, gives the clearest view of the endometrial cavity.¹

Diagnostic hysteroscopy is typically considered when imaging is inconclusive, when symptoms such as abnormal uterine bleeding or recurrent pregnancy loss point to a structural cause, or when implantation failure warrants a thorough uterine cavity evaluation. It relates closely to SIS (Saline Infusion Sonohysterogram), which offers a less invasive first-look option. When SIS identifies a lesion, diagnostic hysteroscopy confirms it visually and can proceed directly to treatment through operative hysteroscopy in the same session.²

This content is for educational purposes only and does not constitute medical advice. Consult an RRM clinician or healthcare provider for guidance specific to your situation.