Sonohysterosalpingography: advantages and disadvantages

Sonohysterosalpingography is an innovative, non-radiological method of evaluating fallopian tube patency and uterine shape with results comparable to those of hysterosalpingography .

This is an examination that is carried out in an outpatient clinic. It is carried out by injecting air and physiological solution (or specific foams for ultrasound) through the cervix, into the uterus, all under ultrasound control.

The exam allows the doctor to evaluate the lining of the uterus (endometrium), the shape of the uterus, and the fallopian tubes.

This exam is part of the initial assessments of couple sterility as an alternative to hysterosalpingography.

It can be performed in 2D or 3D ultrasound mode.

The use of specific contrast agents allows a better definition of the exam.

How to prepare for sonohysterosalpingography

• The examination is done between 5 pm and 12 pm (preferably between 10 and 12 pm in the case of regular cycles) or in general in the proliferative-preovulatory phase.
• An ongoing pregnancy should be excluded and infections should be excluded by performing a preventive vaginal swab (not always necessary).
• sexual intercourse should be avoided from the first day of the last menstrual period until the day of the examination.
• the informed consent to the examination must be signed
• the doctor may recommend an antispasmodic drug to be taken one hour before the exam, and also an antibiotic prophylaxis. In any case, each center will inform the patient how to prepare for the procedure. The latest guidelines do not provide for either the vaginal swab or the antibiotic.

Contraindications to the examination

Sonohysterosalpingography cannot be done on a woman who is pregnant or thinks she may be pregnant. It should not be performed in the presence of vaginal infections or pelvic inflammation. It should not be performed in the presence of particular pathologies and not even in the case of cardiac or respiratory diseases which can cause serious complications in the event of vagal reflexes.

How the exam is done

Before proceeding with the diagnostic test, a preliminary ultrasound is performed.

A balloon catheter is inserted through the cervix into the uterine cavity.

After inserting the catheter into the uterus, a transvaginal ultrasound is performed again to verify the position of the catheter and the balloon.

The physiological solution or the foam is injected while the doctor proceeds with the ultrasound examination.

Side effects

During the examination, pain (from mild to severe), sweating, nausea, vomiting may be experienced.

Bradycardia or fainting may also occur

After the examination you may experience pelvic pain, sweating, nausea, vomiting, and you may experience vaginal blood loss (slight).

Complications are rare and may include fever, pelvic inflammation or infection, and peritonitis.