An alternative to the HSG is a sonohysterogram (SHG) or saline infusion sonogram (SIS).
A sonohysterogram is usually performed in our office at the same time in your cycle as the HSG would have been. The test begins with a transvaginal ultrasound. Once this has been completed, a speculum is inserted, the cervix is cleaned, and a thin tube (catheter) is introduced into the uterus. The speculum is then removed and the ultrasound probe is re-inserted.
Your physician will use the catheter to slowly fill your uterus with a sterile saline solution. This will enable your doctor to evaluate the size, shape, and contour of your uterus. As with the HSG, the sonohysterogram may be mildly uncomfortable, and you may experience some cramping as the saline solution is injected. We suggest that you take ibuprofen or acetaminophen before the examination in order to minimize any cramping. You will also be given an antibiotic to prevent the development of an infection.
Following the exam, some saline may drain out of your vagina, so be prepared to wear a pad to protect your clothing. Walking around after the procedure may help you feel better sooner. Some of our patients prefer that their spouse or a friend drive them home after either an HSG or sonohysterogram; others feel just fine and return to work. Light spotting is not uncommon for a day or two after either procedure.