When pregnancy does not happen as expected, identifying the cause can be just as important as choosing treatment. Problems inside the uterus, including polyps, fibroids and adhesions, may sometimes affect fertility without obvious symptoms. Hysterosonography can provide detailed information about the uterine cavity and may complement other fertility investigations. For women in London, Harrow, Brentford and Northwood, this post explains how hysterosonography works and when it may be appropriate.
What Is Hysterosonography for Fertility?
Hysterosonography, also called saline infusion sonography or sonohysterography, is an ultrasound-based examination used to assess the inside of the uterus. During the procedure, a small amount of sterile saline is introduced into the uterine cavity while ultrasound imaging is performed.
The saline gently expands the cavity, helping the clinician see its shape and identify abnormalities that may not be as clearly visible during a standard pelvic ultrasound.
For fertility patients, this can be particularly useful when investigating possible structural causes of difficulty conceiving or recurrent pregnancy loss.
What Can Hysterosonography Detect?
Hysterosonography can help identify abnormalities within the uterine cavity, including:
- Endometrial polyps, which are growths arising from the uterine lining
- Submucosal fibroids, which project into the uterine cavity
- Uterine adhesions, sometimes called Asherman's syndrome
- Abnormalities in the shape of the uterine cavity
- Other structural changes that may require further assessment
Identifying these problems may help a fertility specialist determine whether treatment or additional investigation is appropriate before proceeding with fertility treatment.
Is Hysterosonography the Best Fertility Test?
There is no single diagnostic test that is best for every fertility patient. Hysterosonography is valuable for examining the uterine cavity, but fertility assessment usually involves several components.
Depending on a patient's history, investigations may include ovulation assessment, blood tests, pelvic or transvaginal ultrasound, assessment of the fallopian tubes and evaluation of the male partner's fertility.
A Consultant Gynaecologist and Obstetrician with specialist interests in fertility, gynaecological ultrasound and minimal access surgery can provide fertility assessment alongside diagnostic ultrasound and procedures such as hysterosonography, allowing investigation to be tailored to the individual's circumstances.
Hysterosonography vs Hysteroscopy: What Is the Difference?
Although the names sound similar, hysterosonography and hysteroscopy are different investigations.
Hysterosonography uses ultrasound after saline has been introduced into the uterus. It is primarily a diagnostic examination and does not involve inserting a camera into the uterine cavity.
Hysteroscopy uses a thin telescope, called a hysteroscope, to directly examine the inside of the uterus. It can be diagnostic and, in appropriate circumstances, therapeutic. For example, polyps or certain fibroids may be treated during hysteroscopic surgery.
The most appropriate investigation depends on the suspected problem, symptoms and previous fertility history.
Where Can Fertility Patients Access Care?
Women seeking fertility and gynaecological assessment across London, Harrow, Brentford and Northwood may require different investigations depending on their circumstances.
Specialist gynaecological and fertility care is available through consulting locations including Harrow, Brentford and Northwood. Clinical interests span fertility, ultrasound, early pregnancy problems and minimal access gynaecological surgery.
This combination can be useful when a fertility investigation identifies a structural problem that may subsequently require specialist treatment.
Frequently Asked Questions
Is hysterosonography painful?
Hysterosonography can cause temporary cramping or discomfort, particularly when the saline is introduced. Experiences vary between patients, and your clinician can explain what to expect and how discomfort can be managed.
Can hysterosonography improve fertility?
Hysterosonography itself is primarily a diagnostic test and is not generally considered a fertility treatment. Its value is in identifying abnormalities within the uterus that may affect conception or pregnancy and may require further management.
Is hysterosonography better than a normal ultrasound?
Hysterosonography can provide more detailed information about the inside of the uterine cavity than a standard pelvic ultrasound in certain circumstances. However, both tests have different purposes, and the appropriate investigation depends on the patient's symptoms and clinical history.
Is hysterosonography the same as hysteroscopy?
No. Hysterosonography uses saline and ultrasound to assess the uterine cavity, while hysteroscopy uses a small camera to directly view the inside of the uterus. Hysteroscopy can also allow certain abnormalities to be treated during the same procedure.
When is hysterosonography recommended during fertility investigations?
Hysterosonography may be recommended when a clinician needs more information about the uterine cavity, particularly when there is a suspicion of polyps, fibroids, adhesions or another structural abnormality. The timing depends on the patient's menstrual cycle, fertility treatment plans and individual circumstances.
Making an Informed Fertility Investigation Choice
Hysterosonography can be an important diagnostic option, but it is not automatically the best test for every fertility patient. A thorough assessment helps determine whether hysterosonography, hysteroscopy, ultrasound or another investigation is appropriate. Women in London, Harrow, Brentford and Northwood can discuss their symptoms and fertility history with Mr. Parijat Bhattacharjee to determine which investigations may be suitable for their individual needs.
Mr. Parijat Bhattacharjee, FRCOG, FICOG, is a Consultant Gynaecologist and Obstetrician serving women across London, including Harrow, Brentford and Northwood. With more than 20 years of experience, his specialist interests include fertility, gynaecological ultrasound, early pregnancy care and minimally invasive gynaecological surgery. He provides assessment and treatment for a wide range of women's health concerns, including menstrual disorders, endometriosis, fibroids, ovarian cysts and fertility problems.