Diagnostic hysteroscopy may be performed with or without tissue sampling. We can often perform the hysteroscopy at the time of a pelvic ultrasound, streamlining the workup of abnormal uterine bleeding. Small growths such as polyps and fibroids can cause abnormal bleeding, miscarriage, and infertility. Once the cavity is assessed and cancer is ruled out, a plan of care can usually be recommended to treat the patient’s presenting problem.