Uterine Cavity Evaluation: Tests and What They Can Show

What Is a Uterine Cavity Evaluation?

A uterine cavity evaluation examines the inside of the uterus to identify structural findings that may be relevant to fertility, implantation or pregnancy. The uterine cavity is where an embryo implants and develops, so evaluating its shape and internal environment may be an important part of fertility testing in certain circumstances.

Different tests provide different types of information about the uterus. Depending on medical and reproductive history, a fertility specialist may recommend ultrasound, saline sonography, hysteroscopy or another method to evaluate the uterine cavity.

Why Might the Uterine Cavity Be Evaluated?

Uterine evaluation may be recommended as part of an infertility workup, before certain fertility treatments, after recurrent pregnancy loss or when previous imaging, symptoms or treatment outcomes suggest that additional assessment would be useful. The appropriate test depends on the specific clinical question being investigated.

Which Tests Evaluate the Uterine Cavity?

Several tests can evaluate the uterine cavity, and each provides somewhat different information. Your fertility specialist selects an approach based on medical history, previous findings and the reason the cavity is being assessed.

Saline Sonogram

A saline sonogram, also called saline infusion sonography, uses sterile fluid to expand the uterine cavity during ultrasound. This can make the contour of the cavity and certain structural findings easier to visualize.

Hysteroscopy

Hysteroscopy uses a thin camera passed through the cervix to directly visualize the inside of the uterus. Depending on the circumstances, hysteroscopy may be diagnostic or may also allow treatment of certain findings.

Other Imaging

Standard pelvic ultrasound and an HSG can provide additional information about uterine anatomy, although they answer different clinical questions. Your physician can determine which method provides the information needed for your fertility evaluation or treatment plan.

What Can a Uterine Cavity Evaluation Find?

A uterine cavity evaluation can identify structural findings that alter the shape or interior surface of the uterus. Whether a finding affects fertility or requires treatment depends on its type, size and location.

Polyps and Fibroids

Endometrial polyps and fibroids that extend into or distort the uterine cavity may be identified during imaging or hysteroscopy. Their clinical significance varies, and not every finding requires intervention.

Scar Tissue

Intrauterine adhesions, sometimes called scar tissue, can affect the uterine cavity and may occur after certain uterine procedures, infections or pregnancy-related events.

Congenital Uterine Differences

Some people are born with differences in uterine shape or structure that may be identified during fertility or pregnancy-loss evaluation.

Your fertility specialist considers the finding together with reproductive history and treatment goals to determine whether additional evaluation or treatment may be appropriate.