Sonohysterogram

A standard ultrasound exam to investigate potential barriers to pregnancy.

Sonohysterogram

About Sonohysterogram or Sono-HSG

A sonohysterogram (Sono-HSG) is an ultrasound exam that uses sterile saline to separate the front and the back walls of the endometrium (uterine lining). This procedure enables the physician to evaluate the shape of the uterus and whether there are any lesions within the lining that may impact implantation for pregnancy. During the exam, the doctor may also test whether your fallopian tubes are open.

The test is performed by a physician with the help of a sonographer between Day 5 and Day 12 of your menstrual cycle. The test lasts approximately 15 minutes.

A recent baseline pelvic ultrasound should be performed prior to completing your SHG. A pelvic ultrasound and SHG cannot be performed on the same day as per OHIP billing specification.

You may also get this exam for the following indications:

  • Abnormal menstrual bleeding (extremely heavy or unusually light periods)
  • Abnormal menstrual cramps
  • Before IVF treatment (to confirm there are no uterine problems that may interfere with embryo implantation)
  • Mid-cycle spotting
  • Pelvic pain or pressure
  • Post-menopausal bleeding
  • Recurrent pregnancy loss (two or more miscarriages in a row)

During the exam, the doctor may also test your fallopian tubes.  In this case, a small amount of foam-based contrast will be pushed through the fallopian tubes to see if the fallopian tubes are open or blocked.

A sonohysterogram scan image

Steps to Prepare for a Sonohysterogram

  • 1 Call CARE Imaging on Day 1 of your period, Tel: (905) 294-4291. Hrs: Monday to Friday 7:00 am to 3:00 pm.
  • 2 The receptionist will book an appointment that falls between Day 5 and Day 12 of your menstrual cycle. If there is possibility of pregnancy prior to the test, please cancel your appointment.
  • 3 Do not have intercourse starting from the first day of your period leading up to the day after the sonohysterogram.
  • 4 On the day of the exam, we advise that you to take 2 Advil (Ibuprofen) or Tylenol (Acetaminophen) 1 hour before your test. Also, please bring a pad/pantyliner with you as you may experience some watery discharge after the test. You do not need a full bladder.
  • 5 When you arrive for your appointment, you will be asked to empty your bladder and change into a gown, disrobing from the hips down. A sonographer will then explain the procedure to you and have you sign a consent form.
  • 6 Once you are in the exam room, the physician will insert a speculum into the vagina to visualize the cervix. 
  • 7 The physician will introduce a thin catheter through the cervical opening and into the uterus. On the end of the catheter there is a tiny balloon that must be inflated to keep the catheter in place. This balloon acts as a seal so that fluid injected will not escape. This usually causes menstrual-like cramping. 
  • 8 When the catheter has been successfully placed, the speculum will be removed, and the ultrasound probe is introduced to check the balloon placement. 
  • 9 The saline is then injected into the uterus and you may experience more menstrual-like cramping. Ultrasound images are taken and a 3D scan of the uterus is performed to assess the shape of the cavity.
  • 10 If fallopian tube patency is being assessed, a small amount of contrast will be pushed through to see if the fallopian tubes are open or blocked. 
  • 11 A radiologist will review the ultrasound images and formulate a diagnostic report, which is sent to your fertility doctor the next business day.

ALLERGY ALERT : Notify the sonographer if you have a latex allergy (a latex probe cover will be used as a protective cover. An alternative will be provided for those with latex sensitivity).

Investigative and Pre-Treatment Ultrasounds

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Sonohysterogram

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A diagnostic exam to evaluate the shape of the uterus and determine whether the fallopian tubes are open or closed.

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Pelvic Baseline Ultrasound with Antral Follicle Count (AFC)

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A 3D ultrasound to assess the uterus and ovaries for anomalies and to check ovarian reserve.

Ultrasounds that Occur During Treatment

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Follicle Tracking Ultrasound

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A vaginal ultrasound performed during an IUI, IVF or Egg Freezing cycle to assess the number and growth of your follicles. This test helps the doctor know when your ovaries are ready.

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Ultrasound Guided Embryo Transfer

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An ultrasound performed at the time an embryo is transferred into the uterus to help the doctor find the perfect spot.

Pregnancy Ultrasounds

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Early Obstetric Ultrasound

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An abdominal ultrasound that is done to confirm pregnancy, usually between week 5 and 7 of pregnancy, repeated as necessary.

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Nuchal Translucency Ultrasound

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An ultrasound performed in the first trimester of pregnancy to determine your baby's risk of congenital conditions like Down syndrome.

Common Questions About a Sonohysterogram

Knowing more about the ultrasound tests you are being asked to do will help prepare you for the overall experience.  Never be shy to ask a question or seek clarification.