A sonohysterogram is an imaging procedure that allows your healthcare provider to see inside your uterus. It’s simple, safe and relatively painless. And it can help shed light on what’s causing issues like pelvic pain, irregular bleeding and infertility.
A sonohysterogram is a special kind of ultrasound that lets your healthcare provider see inside your uterus. With a sonohysterogram, an ultrasound records structures and shapes inside your uterus while your uterus is filled with saline. A sonohysterogram can help your provider see problem areas in your uterus and uterus lining (endometrium) that may be causing unwanted symptoms, like bleeding, pelvic pain and infertility. It’s also commonly referred to as an SIS.
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The best time to get a sonohysterogram is after your period has ended but before you ovulate, days 6 to 11 of your cycle, counting from your first day of bleeding. This is when the lining of your uterus is thinnest and your provider will be able to see it most clearly. If you are postmenopausal it can be done at any time.
You shouldn’t get a sonohysterogram if you’re pregnant or if you have pelvic inflammatory disease (PID).
A sonohysterogram is done in your provider’s office and is less invasive than other surgical procedures that help your provider see inside your uterus, like a hysteroscopy. It does a better job providing detailed views of structures inside your uterus that may be causing your symptoms than a standard pelvic ultrasound.
A sonohysterogram can show structures in your uterus that may be causing symptoms like pelvic pain, unexplained bleeding or infertility. Your provider may ask you to get a sonohysterogram if:
A sonohysterogram can reveal structures inside your uterus that may be causing these symptoms. A sonohysterogram can show:
Knowing the size, shape and location of various structures inside your uterus can help your provider:
An ultrasound technician takes images while a physician or other provider performs the procedure. Then, a physician (a gynecologist or radiologist) will interpret the findings and write a report that communicates these results with your healthcare provider.
The procedure for a sonohysterogram is a lot like the one for a transvaginal ultrasound — but images are taken while a few teaspoons of sterile saline is slowly put into your uterus with a small catheter. Like a transvaginal ultrasound, a transducer wand is inserted into your vagina and cervix so that it reaches your uterus. Once inside, the wand releases sound waves that record information about the structures inside your uterus. This information is then used to project an image of what your uterus looks like onto a screen that the radiologist or technician doing your procedure can see.
It’s important that you only have a sonohysterogram when it’s safe and when your provider can get the best view of your uterus. To make sure this happens your provider will:
On the day of your sonohysterogram, plan to:
Take care to follow any instructions your provider shares with you to prepare for your sonohysterogram.
Your sonohysterogram should take about 30 minutes. You may feel some minor cramps or discomfort at times during your sonohysterogram. But for the most part, you can expect a quick, painless experience.
Your provider will ask you to pee first so that your bladder is empty and to collect a sample for a pregnancy test. Then, a sonohysterogram happens in three parts. Your provider will:
You should be able to go home and return to your normal routine after your sonohysterogram. You may notice the following symptoms. All are harmless.
A sonohysterogram is low-risk and has few side effects. You may feel uncomfortable at points during the procedure, but taking pain medications beforehand can help. There’s a slight chance of infection, but your provider can take steps to prevent this.
Pay attention to these warning signs that you may have an infection:
Let your healthcare provider know right away if you notice these signs.
Your healthcare provider will contact you once the physician sends over the results from your sonohysterogram. Depending on the results, your provider may prescribe treatments or recommend more imaging — additional views or a different type of imaging procedure — to diagnose your condition.
A hysteroscopy and a sonohysterogram both allow your provider to see inside your uterus. A sonohysterogram is less expensive, less invasive and quicker than hysteroscopy. But it can only be used to diagnose a condition. Hysteroscopy allows your provider to see structures inside your uterus and remove them at the same time if needed.
Hysterosalpingography (HSG) uses radiation instead of sound waves to record structures in your uterus and project them onto a screen. An HSG can show if there’s a blockage in your fallopian tubes that may be causing you fertility issues. These blockages don’t always show up on a sonohysterogram.
A note from Cleveland Clinic
A sonohysterogram can help your provider diagnose all kinds of conditions that may be causing you unpleasant symptoms. The procedure won’t take up too much of your day, and you’re unlikely to notice any side effects other than mild discomfort and some saline drainage. It’s one of the best tools your provider has for inspecting the inside of your uterus, without surgery.
Last reviewed by a Cleveland Clinic medical professional on 01/31/2022.
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