If you follow celebrity news closely, then you may have heard that reality TV star Kim Kardashian had her uterus scraped or “cleaned up” to increase her fertility on a recent episode of Keeping Up With The Kardashians. To be clear, the actual medical term for the procedure is called a hysteroscopy with dilation and curettage (D&C) and come to find out, it’s a fairly common procedure.
With a hysteroscopy and D&C, a camera is placed inside the uterus to search for tissue, fibroids, polyps or any foreign bodies. If anything irregular is detected, it gets removed. It does require anesthesia, but it’s not a complicated procedure. In fact, patients are free to return home that same day without missing work or having to be placed on bedrest. In Kim’s case, there was leftover placenta in her uterus after giving birth to her 22-month-old daughter, North West.
BlackDoctor.org recently spoke with Dr. Desiree McCarthy-Keith, a reproductive specialist in Atlanta, Georgia, to gain some further insights regarding the procedure:
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An overview of the procedure:
“Scraping the uterus is not necessarily a specific medical term for the procedure, but I believe that after Kim had her baby, there was a portion of the placenta or some tissue that was left behind in the uterus and it just kind of got stuck in there so the doctor went in and removed that tissue. With a D&C, you can remove the tissue in the uterus and you can even insert a camera inside the uterus and look and see if there’s a tissue, fibroid or polyp that needs to be removed. But, if there’s a woman who’s having trouble getting pregnant, we don’t just say, 'Let’s have the procedure.' We have to take a good look first."
"A lot of times with fertility treatments, what we do is an ultrasound of the pelvis. With the ultrasound, we can see if there’s a fibroid or if there’s anything irregular in the uterine cavity. There’s also an X-ray test that we do; it’s actually one of the initial tests, where we put dye inside the uterus and take X-rays and watch the dye move through the uterus. It can also show scar tissue, a fibroid, a mass or something. The next step is to go to a surgeon and actually remove and identify what that is.”
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What the procedure involves:
“It depends on what is actually there in the uterus. A hysteroscopy is a procedure that allows us to look inside the uterus and if there’s anything there, we just go ahead and remove it and it’s usually a very brief and minor procedure. It can take less than 30 minutes. You can go home the same day and you may have cramping or spotting for a couple days, but you’ll recover just fine. But it’s not something where you need to be on bedrest or miss work after having it done usually. Again, it really depends on what’s being removed.”
Reasons why a doctor would recommend it or not recommend it:
“A reason why I would not recommend it is that if everything is normal and fine and there’s no evidence that scraping the lining of the uterus is going to increase the woman’s chances of becoming pregnant. The reason why a doctor would recommend it is if there’s a preliminary test that shows an abnormality of the uterus or like I mentioned, an ultrasound showing any irregularity.”
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The pros and cons:
“If there’s a tissue or foreign body inside the uterus, the pro is that you’re removing it and if that’s what’s causing the blockage, you should be able to then become pregnant. The cons are that with any surgical procedure that requires anesthesia, there’s risk of anesthesia and whenever you do a procedure involving the uterus, you can have infections, you can have bleeding, you can have what’s called a perforation of the uterus so if you’re having a D&C or anything like that, the instruments can keep going and poke a hole in the uterus and come out through the other side and injure structures like the bladder and the intestines. That doesn’t happen very often, but it is a complication of having a D&C, hysteroscopy or similar type of procedures.”
Possible risks and dangers:
“It really just depends on the skill level of the surgeon and how extensive the surgery is. D&C is a very routine procedure that most OB/GYNs perform very routinely and the risks are low, but the risks are not zero. In general, it’s a pretty low-risk procedure. But again, you have to have a reason so if there’s absolutely no basis for performing a procedure and you have a bad outcome, then you’re looking back and you have to ask, ‘Was this really necessary to compromise someone’s health for a procedure that didn’t improve anything and that wasn’t needed?’”
On whether it actually helps with fertility:
“The information that I read was that there was leftover tissue in the uterus from Kim’s previous pregnancy so if that’s the case, then yes, it can be a benefit to Kim. But for ladies who are having infertility issues for other reasons – if their tubes are blocked, they’re not ovulating, the man’s sperm count is low, there can be many other things going on so women should definitely not get the impression that if they’re not getting pregnant, the first thing they need to do is have their uterus scraped and that will make everything better. I think it’s a unique for Kim’s situation, but it’s not something we do across the board when we take on women who are having trouble getting pregnant.”
Other things to keep in mind:
“Last week was National Infertility Awareness Week and in the Black community, we don’t realize that this is really a problem for us so for women younger than 35, who’ve been trying to get pregnant for more than a year, they need to see a doctor, a fertility specialist. For women older than 35, their egg supply is lower so if they don’t get pregnant within six months of trying, they need to see a doctor. Don’t get caught up in the hype of one story; come see a specialist to figure it out.”
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