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Westend Centre for Assisted Reproduction Limited

Introductory Information

        Sonohysterogram or Hysterosonogram    
   
   
What is sonohysterogram?
A sonohysterogram is an office based ultrasound procedure that can determine if there are abnormalities inside the uterus that might interfere with pregnancy. It is important to have an evaluation of the uterine cavity with a sonohysterogram or another method before proceeding with an IVF cycle. This test involves no radiation, and there are very few risks from the procedure. Compared to a regular ultrasound, a sonohysterogram is better at detecting abnormalities on the inside walls of the uterus because it involves infusing sterile fluid inside the uterus. This way, the walls of uterus separate from each other and any abnormalities that might have been hiding along the sides of the walls will be easily identified.
 
Here is an example to help understand why sonohysterogram’s are useful. Think of your uterus like a collapsed balloon. If there was a small growth or bump on the inside wall of the collapsed balloon, it might be hard to see since the top and bottom walls are touching each other. However if we inflate the balloon, the small growth will be easier to see, since it will be likely able to hang away from the wall.
 
Traditionally, the “best” way to look for abnormalities inside the uterus was a test called a hysteroscopy, which involves an out-patient procedure using a type of telescope to look inside the uterus. However, in recent years, the technique for a sonohysterogram has become so advanced that it has replaced hysteroscopy as the first procedure to look for abnormalities in the uterus. Compared to a hysteroscopy, a sonohysterogram is less invasive, less expensive and nearly as effective at detecting abnormalities.
 
What kind of problems can a hysterosonogram diagnose?
A hysterosonogram is often recommended for women who are having difficulty conceiving a pregnancy or for women who are having recurrent miscarriages. In some cases a hysterosonogram may be used for a woman who is having abnormal vaginal bleeding. Since a sonohysterogram gives such a detailed view of the inside walls of the uterus, it can identify many types of abnormalities that might prevent a pregnancy from developing. Studies have shown that it can detect over 90% of abnormalities of the uterus. Some of these abnormalities include:
 
  • Polyps
  • Fibroids
  • Scar tissue
  • Uterus Septum
  • Bicornuate Uterus
 
How is a sonohysterogram performed?
The procedure for performing a sonohysterogram is very simple, it usually takes about 5 minutes. The doctor will advise when to schedule a sonohysterogram, you will need to call the office on the first day of your menstrual cycle/period. You will be given an appointment after the bleeding from the period has ended but before it is thought that ovulation might occur. This ensures that the uterine lining is as thin as possible. This is important since it will assist the doctor in visualization of the cavity. The hysterosonogram is performed in the office. Using a speculum, a very thin, soft, flexible plastic catheter will be inserted through the vagina and cervix into the lower part of the uterine cavity. The speculum is then carefully removed so as not to disturb the catheter. A vaginal ultrasound probe is then placed into the vagina. Through the catheter, a small amount of saline (sterile salt water) is injected into the uterine cavity to separate the walls.
 
Now both Sonohysterogram and Hysterosalpingogram can be done together in office, called Sonohysterosalpingogram.

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