What is hysteroscopic embryo removal like?

Diagnostic and operative hysteroscopy—commonly referred to as “hysteroscopic embryo removal” or “hysteroscopic pregnancy termination”—is a minimally invasive surgical procedure used to visualize the uterine cavity and remove early intrauterine pregnancy tissue, typically in cases of missed miscarriage, incomplete abortion, or elective termination up to approximately 10–12 weeks’ gestation. It is performed under direct visualization using a thin, lighted hysteroscope inserted through the cervix, without the need for cervical dilation beyond what is required for instrument passage.

This technique offers several advantages over traditional methods such as dilation and curettage (D&C), including enhanced precision in tissue removal, reduced risk of uterine perforation or cervical trauma, lower incidence of intrauterine adhesions (Asherman syndrome), and faster postoperative recovery. However, it requires specialized training and equipment, and its feasibility depends on gestational age, uterine anatomy, and operator expertise. Contraindications include active pelvic infection, uncontrolled coagulopathy, and suspected ectopic pregnancy.

Patient selection, thorough preoperative counseling—including discussion of alternatives (e.g., expectant management, medical abortion with mifepristone/misoprostol), procedural risks (e.g., fluid overload from distension media, thermal injury if energy devices are used), and post-procedure expectations—is essential. Outcomes are generally favorable when performed by experienced practitioners in appropriate clinical settings, with high rates of complete tissue removal and low complication rates.