Sonohysterosalpingogram (SonoHSG)

Posted on October 25, 2022

Sonohysterography is one of a few tests that can be used to evaluate the fallopian tubes, uterine cavity, and endometrium. This test is best performed between days 6-11 of the menstrual cycle, when the lining is thin, for better visualization of structural defects within the uterine cavity. It also ensures that there is not an early pregnancy growing. Initially a gynecological ultrasound is done vaginally in a routine fashion, and measurements are taken of the uterus and ovaries. The ovarian antral follicular count (AFC) can also be recorded if it has not been done earlier in the cycle. Thereafter a Sonohysterogram catheter is placed through the cervical canal and the bulb is inflated allowing a seal to be formed, that prevents back flow of saline through the cervix and into the vagina. The Sonohysterogram is then performed while the infusion is started to identify any uterine defects such as various uterine polyps, scar tissue and fibroids. Thereafter, the injection of shaken saline (causing bubble formation in the saline) allows further views within the uterine cavity to visualize the fallopian tubes. The bubbles are followed through the tubal openings through the tubes and ultimately into the abdomen. If the saline bubbles are seen in the peritoneal cavity or abdomen, then tubal patency is confirmed. If bubbles/saline accumulate in a dilated tube, then a blocked distal tube or hydrosalpinx is diagnosed. If the bubbles/saline do not enter the tubal openings, then a proximal tubal obstruction is diagnosed.


A Sonohysterogram is used to examine the uterine cavity and lining for abnormalities related to a variety of signs and symptoms. This test might be recommended for the following reasons:


The process of having a Sonohysterogram takes around 30 minutes or less. It’s typically performed after your menses and prior to ovulation (cycle day 8, 9, 10). For this test you will be undressed from the waist down, lying on an exam table, and can expect the following:


It is common for saline water to leak from the vagina after the test, using a pad will help with this (to avoid infection, do not use a tampon for the next 24hrs). Most women immediately resume normal activity and return to work or home. However, there are some side effects that you might experience including:

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