Sonosalpingography

Sonosalpingography (SSG), also known as a saline infusion sonohysterography (SIS) or hysterosalpingo-contrast sonography (HyCoSy), is a non-invasive ultrasound-based diagnostic procedure used to assess the patency of the fallopian tubes and to evaluate the uterus cavity. This procedure is an important tool in the evaluation of female infertility, providing valuable information about potential obstacles to fertilization.

Procedure

Sonosalpingography involves the introduction of a saline solution, sometimes mixed with a contrast agent, into the uterine cavity through the cervix. The saline or contrast medium enhances the ultrasound images, allowing for a clearer view of the uterine cavity and fallopian tubes. The procedure is typically performed in the first half of the menstrual cycle, after menstruation has ended but before ovulation, to ensure that the patient is not pregnant.

During the procedure, a speculum is inserted into the vagina to visualize the cervix, similar to a Pap smear examination. A thin catheter is then passed through the cervical canal into the uterine cavity. Once the catheter is in place, the saline solution, with or without contrast, is slowly infused. The ultrasound transducer is used to visualize the flow of the solution through the uterus and fallopian tubes, assessing for any abnormalities or blockages.

Indications

Sonosalpingography is indicated for women experiencing infertility, recurrent pregnancy loss, or before certain fertility treatments such as in vitro fertilization (IVF). It helps in diagnosing conditions such as:

• Endometrial polyps
• Uterine fibroids
• Adhesions (scar tissue within the uterus)
• Congenital uterine anomalies
• Fallopian tube obstruction

Advantages

The advantages of sonosalpingography include:

• Non-invasiveness
• No exposure to ionizing radiation
• Lower cost compared to other diagnostic methods like hysterosalpingography (HSG) or laparoscopy
• Can be performed in an outpatient setting
• Provides real-time images

Risks and Complications

Sonosalpingography is generally considered safe. However, as with any medical procedure, there are potential risks and complications, including:

• Discomfort or pain during the procedure
• Infection, although rare
• Allergic reaction to the contrast material, if used

Conclusion

Sonosalpingography is a valuable diagnostic tool in the assessment of female infertility, offering a less invasive, cost-effective alternative to traditional methods. By providing detailed images of the uterus and fallopian tubes, it aids in identifying potential barriers to pregnancy, thereby guiding further treatment.