A sonohysterogram is an imaging test that lets a gynecologist see the inside of the uterus more clearly. It can help detect conditions such as fibroids, polyps, or other abnormalities in the uterine lining.
During a sonohysterogram, the doctor may also be able to see whether the fallopian tubes are blocked. Blocked fallopian tubes can sometimes be related to infertility.
This test is performed by a gynecologist in a hospital, imaging center, or doctor’s office. It may be covered by health insurance or paid for out of pocket.
What it's used for
A sonohysterogram may be recommended for:
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Suspected or confirmed uterine abnormalities, especially fibroids, which are small benign tumors that develop gradually and may cause heavy bleeding and anemia
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Differentiating uterine polyps
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Investigating abnormal uterine bleeding
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Evaluating women with unexplained infertility
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Recurrent miscarriages
According to the American College of Obstetricians and Gynecologists (ACOG), a sonohysterogram is usually scheduled after menstrual flow has stopped and before ovulation, often by day 10 of the menstrual cycle.
However, a sonohysterogram is contraindicated during pregnancy or if pregnancy is suspected. It should also not be performed in the presence of vaginal infections.
How it's done
A sonohysterogram is performed with the patient in the gynecologic (lithotomy) position, as for a Pap smear. It usually involves the following steps:
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Inserting a sterile speculum into the vagina
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Cleaning the cervix with an antiseptic solution
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Inserting a catheter into the uterine cavity
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Injecting sterile saline solution
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Removing the speculum
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Inserting the ultrasound device, called a transvaginal probe, into the vagina to send images of the uterus to a monitor
In patients with a dilated or incompetent cervix, a balloon catheter may be used to keep the saline solution from flowing back into the vagina.
Once the sonohysterogram is complete, the gynecologist can review the images and recommend treatment for any uterine abnormality found.
Hysterosalpingography is a different imaging test used to evaluate fertility problems. Unlike a sonohysterogram, it uses contrast dye and X-rays to assess the uterus and fallopian tubes.
Is a sonohysterogram painful?
A sonohysterogram may cause pain, discomfort, or cramping during the exam.
However, the test is usually well tolerated. The doctor may recommend a pain reliever or anti-inflammatory medication before and after the exam.
After a sonohysterogram, mild vaginal irritation may occur, especially in patients with sensitive vaginal mucosa. In rare cases, complications such as infection or increased menstrual bleeding can occur.