The hysterosalpingogram (HSG) and sonohysterogram (SHG) are two tests that can be used to evaluate the uterus. The goal of these procedures is to see if there are any fibroids, polyps, or scar tissue that are disrupting the lining and could potentially affect implantation of a pregnancy. The HSG also tests to see if your Fallopian tubes are open, and an additional component of the SHG called the FemVue can provide this information as well. Your doctor will specify which of the two tests you should undergo depending on your circumstances.
The Hysterosalpingogram
What happens during an HSG?
Our team performs HSGs in the radiology department. During the HSG, your provider will place a speculum in the vagina (just like when you get a pap smear) in order to see the cervix. The cervix will be held steady using an instrument, and a small catheter is then inserted into the cervix and dye injected through the cervix into the uterus. While the dye is being injected, X-rays are being taken to follow the passage of the dye through the uterus, into the tubes, and out of the tubes into the abdomen.
Normal uterus and open tubes on hysterosalpingogram
The Sonohysterogram
What happens during an SHG?
Our team performs SHGs in the office. During the SHG, your provider will place a speculum in the vagina (just like when you get a pap smear) in order to visualize the cervix. A thin catheter is then inserted into the cervix and saline (salt water) injected through the cervix into the uterus. While the saline is being injected, a vaginal ultrasound will be performed in order to see the inside of the uterus. If you are also having your tubes evaluated at this time (called a FemVue), bubbles will then be injected through the same catheter in order to see if they spill out the ends of your tubes. If so, this suggests that your tubes are open.
Normal uterus cavity on sonohysterogram
Are These Tests Painful?
Most patients do experience pain during these tests, but the painful parts typically last less than five minutes. The pain is frequently described as strong menstrual cramps. The pain usually resolves at the conclusion of the procedure — most patients feel better by the time the procedure is done!
How Should I Prepare For These Tests?
These tests are performed between days five and 12 of your cycle — your period should be either slowing down or resolved at that time, but you have not yet ovulated. This is to ensure that we do not disrupt a very early pregnancy that is too small to be detected. We recommend taking 600 mg of ibuprofen (or Advil, motrin) 30 minutes before your procedure in order to help with the discomfort.