| Sonohysterosalpingography | |
|---|---|
| Other names | Sonohysterosalpingography, Sonosalpingography, HyCoSy, HyFoSy |
Sonohysterosalpingography (SHSG), also commonly known as Hysterosalpingo-contrast sonography (HyCoSy), is a specialized, minimally invasive gynecological imaging technique used to evaluate the openness of the fallopian tubes and inspect the uterine cavity. It is primarily utilized in the diagnostic workup of female infertility and recurrent pregnancy loss.
Unlike standard sonohysterography, which relies entirely on saline to distend the uterus, sonohysterosalpingography incorporates specialized contrast media—such as microbubble solutions, echogenic gels, or agitated saline-air mixtures—to trace fluid movement dynamically through the reproductive tract under real-time transvaginal ultrasonography. During the past decade Hysterosalpingo-Foam Sonography (HyFoSy) has been developed as a safe and less painful alternative.
Sonohysterosalpingography is indicated for the assessment of the female reproductive anatomy when tubal or uterine pathology is suspected. Main clinical indications include:
The procedure is generally safe but is contraindicated under certain clinical conditions to avoid severe complications:
The procedure is outpatient-based, requiring no anesthesia.
The diagnostic accuracy of sonohysterosalpingography relies on the choice of contrast agent. Because standard saline is translucent (anechoic) on ultrasound, it is difficult to track. Specialized contrast agents are utilized to increase echogenicity, appearing bright white on the ultrasound display to allow clear visualization of fluid movement.