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Hysterosalpingogram and Sonohysterosalpingogram

Infertility is often caused by fallopian tube blockages or other problems with the uterus.

Hysterosalpingogram (HSG)

A hysterosalpingogram is an X-ray test that looks at the inside of the uterus and fallopian tubes, and the area around them. The test is used for several reasons.

  • Determining if your fallopian tubes are blocked and see where the blockage is located — at the junction of the tube and uterus (proximal) or at the end of the tubes (distal). A blockage could prevent an egg from moving through a fallopian tube to the uterus or prevent sperm from moving into a fallopian tube and fertilizing an egg.
  • Finding problems in the uterus such as an injury, abnormal shape or structure, polyps, fibroids or adhesions. The test may also find problems on the inside of the uterus that prevent an embryo (fertilized egg) from implanting on the uterine wall.
  • Seeing whether surgery to reverse tubal ligation has been successful.

A hysterosalpingogram involves the injection of radiographic dye into your uterus, and it must be performed by a radiologist or someone trained in radiographic imaging. The uterus fills with this dye, and if your fallopian tubes are clear, it will spill into your abdominal cavity. Pictures are taken using a steady beam of X-ray (fluoroscopy) as the dye passes through the uterus into the fallopian tubes.

Sonohysterosalpingogram (SHG)

A sonohysterosalpingogram is an innovative, non-radiologic method of assessing fallopian tubes and uterine shape with results that are comparable to HSG. Testing with sonohysterosalpingogram is typically less expensive than with hysterosalpingogram with the added benefits of:

  • no exposure to radiation
  • because no X-ray equipment is required, the procedure is usually done in the office, eliminating the need for an outpatient hospital visit.

A sonohysterosalpingogram uses sterile saline and air, which is passed through the cervix into the uterus and visualized by transvaginal ultrasound. The test allows the fertility doctor to assess the uterine lining, shape and texture, as well as the fallopian tubes. The test may cause some cramping as it is being performed.

Saline Sonogram (SIS)

A saline sonogram, also known as a saline infusion sonogram, a sonhysterogram or an SIS is an ultrasound test done after a saline solution has been infused into the uterus. The test is used to detect uterine abnormalities such as polyps or cysts. The saline solution distends the uterus and acts as a contrast to the internal structure, which provides more detail than a conventional ultrasound.


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