SONO HSG in the diagnosis of female infertility – preparation for the examination, course, results and possible complications

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The SONO HSG examination is defined as the least invasive diagnostic procedure that allows the doctor to assess the patency of the fallopian tubes. In this examination, using ultrasound waves, an image of the uterine cavity and fallopian tubes is obtained. When should this test be performed and are there any contraindications for the procedure? How should you prepare for the SONO HSG test and what is its course?

Women’s infertility and its causes

In most cases, female infertility is caused by hormonal and ovulation disorders. Infertility can result from menopause, an egg not shedding properly during ovulation, or the inability to burst. The causes of female infertility are very large, therefore it is very important to diagnose this problem. The most common causes of infertility in women are:

1. polycystic ovary syndrome – is a common hormonal disorder characterized by an excessive amount of male sex hormones in the blood. The excess of androgens causes the follicle to die and the formation of more and more cysts on the ovary. The presence of these cysts makes the woman infertile;
2. endometriosis – is a disease in which the endometrium, i.e. the endometrium, migrates outside the uterine cavity and takes root in other organs and tissues. Usually the mucosa is located in the ovaries or fallopian tubes, but there are cases of migration to distant organs such as the lungs and intestines. Endometriosis causes not only infertility, but many other serious conditions;
3. polyps – most often appear in the body or cervix. They are formed from the mucosa and form flat, oblong formations. They cause infertility and profuse bleeding from the genital tract;
4. uterine fibroids – these are benign tumors that are also referred to as fibroids. Uterine fibroids are responsible for long periods, problems getting pregnant and miscarriages;
5. pelvic inflammatory disease – this condition is most often caused by inflammation of the pelvis. Chronic inflammation causes scarring, abscess formation, and damage to the fallopian tubes, which in turn leads to infertility;
6. ovarian failure – if premature ovarian failure occurs, it means the depletion of the primary follicle supply in the ovaries. This may be due to, for example, treatment of a neoplastic disease;
7. previous operations – any operations that were performed within the abdominal cavity may make it impossible for a woman to get pregnant.
8. hyperprolactinemia – this is a disorder where the levels of prolactin in the blood are too high. Too much prolactin causes ovulation disorders, missed or irregular periods, and difficulty getting pregnant
9. diseases of the adrenal glands, thyroid gland, diseases of the pituitary gland – these are diseases associated with hormonal disorders. Endocrine imbalance is a common cause of female infertility;
10. sexually transmitted diseases;
11. obesity or underweight;
12. disorders in the functioning of the immune system;
13. alcoholism;
14. hereditary diseases.

For more information on male and female infertility, see Infertility

SONO HSG examination in the diagnosis of female infertility – basic information

The SONO HSG examination is also called ultrasound hysterosalpingography. Despite such a complicated name, the SONO HSG test is one of the least invasive procedures performed during the diagnosis of female infertility. During this examination, the doctor assesses the uterine cavity and fallopian tubes. This method of examination is used in the diagnosis of infertility to assess the patency of the fallopian tubes and to detect possible abnormalities in the woman’s genital tract.

Abnormalities that can be diagnosed during the SONO HSG examination are adhesions, septum, fibroids, tumors, polyps or endometriosis foci. These diseases and conditions, as mentioned above, are very often responsible for female infertility or difficulties in getting pregnant. When describing the SONO HSG test, it is worth mentioning the HSG test, which also helps to assess the patency of the fallopian tubes and is considered its basic form.

The HSG examination takes a series of X-rays of the smaller pelvis. Contrast should be reported in this test, so if a woman is allergic to contrast, it is decided to perform the SONO HSG test.

Do you want to find out what test should be performed in case of suspected infertility? Check: Diagnosis of infertility in women – what tests should be performed?

When should the SONO HSG test be performed?

The SONO HSG examination is performed when a woman is suspected of being infertile, especially when an abnormality in the shape or structure of the uterus and obstruction of the fallopian tubes are anticipated. SONO HSG tests are performed in the first half of the menstrual cycle, i.e. between the 8th and 12th day, when postmenstrual spotting has completely stopped. SONO HSG testing is never performed during menstruation, even if there is only slight spotting.

Do you know how infertility is treated? Read: Infertility Treatment Methods

Contraindications for the SONO HSG test

The SONO HSG test is a minimally invasive procedure, but not every woman can decide to undergo it. Contraindications for the SONO HSG test are pregnancy, vaginal bleeding or spotting, inflammation in the genital area, and allergy to the administered contrast in the case of the standard HSG test.

What should you know about male infertility? Read: Andrology and Male Infertility

How should you prepare for the SONO HSG test?

Although the SONO HSG test is minimally invasive, it should be properly prepared. The patient must have a bacteriological vaginal swab in the cycle that precedes this test. The result of the smear test will help to exclude inflammation in the genital area. If inflammation is found, treatment should be initiated first and reappointment for the SONO HSG examination after complete recovery.

A few days before the planned SONO HSG procedure, a vaginal biocenosis should also be performed, i.e. its cleanliness should be assessed. The patient should be fasting on the day of the examination. It is recommended that an analgesic tablet be taken one hour before the examination. In some offices, a painkiller is given just before the test. Before the SONO HSG examination, virological tests should also be performed.

Step by step SONO HSG examination

The SONO HSG examination takes place in a doctor’s office on a gynecological chair. Initially, the doctor conducts a basic ultrasound examination to exclude significant pathologies of the uterus and appendages. Initial examination also allows for the exclusion of unforeseen pregnancy. Then, with the help of a speculum, the doctor widens the vaginal walls, cleans the cervix with a disinfectant and introduces a disposable catheter with a balloon. After filling the balloon, the doctor administers saline solution, which fills the uterine cavity and then enters the fallopian tubes.

All these activities take place under constant sonographic control. On the monitor, the doctor observes the shape and size of the uterine cavity and the flow of contrast through the fallopian tubes. The SONO HSG examination is relatively short. On average, people spend 15 to 20 minutes on the gynecological chair. It is not uncommon that the fluid administered during the procedure helps to clear the clumped fallopian tubes, thanks to which a woman can become pregnant.

The results of the SONO HSG study

During the SONO HSG examination, the patient is kept informed by the doctor about its progress. After the SONO HSG test is performed, the woman immediately receives the result in the form of a description. The doctor conducting the examination also informs the patient about further recommendations and planned consultation visits.

Possible complications after the SONO HSG examination

The patient can go home immediately after the SONO HSG examination. The treatment does not require hospitalization and convalescence. However, immediately after the examination, a woman may experience discomfort, including abdominal pain and uterine contractions. It is also worth noting that after the SONO HSG test, the patient may experience minor complications. In addition to pain and unpleasant contractions, patients may develop adnexitis as well as vaginal infections. If you suspect an infection, consult your doctor immediately.

Badanie I’M HSG – dinner

The SONO HSG examination can be performed under the National Health Fund, if a referral is issued. It is worth noting that the primary care physician cannot issue such a referral. A specialist doctor, i.e. a gynecologist, gynecologist-obstetrician or gynecologist-endocrinologist, is authorized to issue a referral for the SONO HSG examination. If the test is performed in a private office, a referral will not be needed.

It happens, however, that in private clinics an order for ovarian patency assessment is required. Patients who do not benefit from the financial benefits of the National Health Fund must take into account quite high costs when deciding to undergo the SONO HSG examination. Assessment of the patency of the fallopian tubes in a private office can cost from 500 to 1000 zlotys.

How much should I pay for other tests in the diagnosis of infertility? Check: How much do women’s fertility tests cost and where to do them?

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