(Other names for the test: Sonohysterography, 3D Sono-HSG, SIS)
What is Hydrosonography?
Hydrosonography refers to a series of pelvic ultrasound scans to examine the uterine cavity and the fallopian tubes. To obtain images of the interior of these organs, a sterile physiological liquid (normal saline) is introduced through the vagina into the uterus and tubes. In this test, unlike an X-ray, there is no exposure to iodine or to radiation. The test is performed in conjunction with the Obstetrics and Gynecology Ultrasound Unit.
When is Hydrosonography used?
The test is generally performed within the context of fertility testing for women, when there is a need to clarify unusual symptoms in the uterus such as polyps, abnormal bleeding, repeated miscarriages, or in preparation for IVF treatment. The test is useful for confirming or ruling out structural abnormalities, growths, blockages or adhesions in these organs.
Preparation for the Test
- The test is performed during the first half of the period, before ovulation, 5-11 days after menstrual bleeding (not stains).
- On the first or second day of your period, call to arrange an appointment. See contact details on this page.
- Avoid engaging in intimate relations from the start of your period until after the test. This will ensure that you are not pregnant at the time of the test.
- Please bring a referral and a payment guarantee from your Kupat Cholim (HMO).
- Inform your doctor of any past pelvic infections or heart disease that requires preventative antibiotic treatment.
- You can eat a light breakfast on the morning of the test but not too close to it.
- Starting two days before the test, we recommend taking 100mg of a Doxycycline-type antibiotic (if you are not allergic) twice a day for 5 days. You should take it with food and and avoid lying down within a half hour of taking it. Ask your doctor or the IVF Unit for a prescription.
- We also recommend taking 400mg of painkiller (NSAIDS, Advil, Ibuprofen or similar) about 30-60 minutes before the test. You can buy this without a prescription at any pharmacy.
- It's best to have someone accompany you when you come for the test.
- Empty your bladder before the test.
- In the IVF Unit, you will be asked to sign your agreement to having the test. The agreement form explains the possible complications, which include period-like pains, low risk of infection and light bleeding. Among rarer complications noted in medical literature (and mentioned on the form) are a re-awakening of chronic pelvic infections and perforation of the uterus (in extreme cases, this may require removal of the uterus).
What happens during the actual test?
A gynecologist performs the test, usually assisted by an ultrasound technician or a doctor specializing in ultrasound.
The test lasts 5-10 minutes.
The patient lies on a gynecological testing chair. After covering the groin and thighs with sterile cloth, the doctor will insert a device (speculum) that enables observation of the cervix. Occasionally, the doctor may also use a device to hold the cervix (tanculum). The area will be sterilized and then a flexible, soft tube of about 2mm diameter will be inserted into the cervix. At the end of the tube is a balloon that expands inside the uterus to a diameter of 5mm. Through the tube and while scanning, the sterile saline solution is dripped inside.
The ultrasound monitors how the uterus and the fallopian tubes fill up with liquid. After the area has filled up, the doctor or technician take a series of photos. These are later computer-processed to generate a 3-D reconstruction of the uterine cavity.
During the injection of the solution, you may feel discomfort similar to period pains, which may continue for a few hours after the test as well. For this reason it is highly recommended that you come for the test with someone who can help you and drive you home, and also that you take pain medication beforehand.
Test Results
The doctor interprets the results on the spot. You will receive official confirmation of the results and the photos immediately after the test.
After the Test
You may feel discomfort or pain in the pelvis or abdomen following contraction of the uterus. This is normal and should pass within a short time. If necessary, you can take painkillers (like Acamol, Optalgin, Advil, Nurofen, Ibuprofen, etc.) during the day after the test.
Some of the solution inserted may drip from the vagina. There is sometimes a minor amount of vaginal bleeding, usually from the cervix.
Please see your doctor in the case of bleeding that lasts more than two days, strong pain that does not react to treatment, or a high fever. Let the testing staff know of any complications.
We recommend that you talk to your referring doctor about the test parameters and possible risks.