The “sono-HSG” is an ultrasound exam in which saline is injected through the cervix into the uterine cavity to illustrate the inner shape of the uterus and degree of openness (patency) of the fallopian tubes. The exam is performed in one of our center by a Clinician and an assistant.

Sonohysterography can find the underlying cause of many problems, including abnormal uterine bleeding, infertility, and repeated miscarriage. It is able to detect the following:

  • Abnormal growths inside the uterus, such as fibroids or polyps, and information about their size and depth.
  • Scar tissue inside the uterus.
  • Abnormal uterine shape.
  • Problems with the lining of the uterus.
  • Whether the fallopian tubes are open or blocked.

This procedure is performed between cycle day 5-12, cycle day 1 is the first day of full flow of your menstrual cycle. There is no special preparation needed for the exam, although you may want to empty your bladder prior to the test.

You may experience some discomfort with this procedure and may take Tylenol, Advil or Motrin one hour prior to the procedure to decrease any cramping, which may occur. Occasionally, prophylactic antibiotics may be prescribed, if you have a known history of pelvic infections.


You will be asked to lie on your back with your feet placed as for a pelvic exam. A device called a speculum is inserted into the vagina. The speculum holds the walls of the vagina apart to allow the cervix to be viewed. The cervix is then cleaned with a betadine solution. (Please make us aware if you are allergic to shellfish or iodine). One of two methods may be used to insert the saline. In one method, the cervix is grasped with a device to hold it steady. An instrument called a cannula is then inserted into the cervix. In the other method, a thin plastic tube is passed into the cervical opening. The tube has a small balloon at the end that is inflated. The balloon keeps the tube in place in the uterus. The speculum is removed, and the transvaginal ultrasound probe is placed into the vagina. The fluid slowly is placed through the cannula or tube into the uterus and fallopian tubes. The fluid may cause cramping. If the tubes are blocked, the fluid will cause them to stretch. Ultrasound images are made as the saline fills the uterus and tubes. You may be asked to change position. If there is no blockage, the fluid will spill slowly out the far ends of the tubes. After it spills out, the fluid is absorbed by the body. After the images are captured, the transvaginal ultrasound probe and cannula or tube are removed.

Risks & Side Effects

Most women are able to go home right away and are back to their normal activities that day. Some of the following symptoms may occur after the test:

  • Cramping
  • Spotting or light bleeding
  • Watery discharge

This test is very safe, but there is a rare risk of pelvic infection. Call your ob-gyn if you have any of the following symptoms:

  • Pain or fever in the day or two after you go home
  • A change in the type or amount of discharge


If the saline solution does not flow easily through the tubes, tubal disease may be present. The blockage can interfere with the fertilization process and may be contributing to your infertility.

If the saline flows freely through the fallopian tubes, this will indicate that there is a passageway for the sperm to meet the egg and begin the fertilization process. Healthy, open tubes enable the embryo to travel safely to the uterus.