What Is Sonohysterogram with Contrast?
A sonohysterogram with contrast is an advanced ultrasound procedure used to evaluate both the uterine cavity and fallopian tube patency. Instead of using only sterile saline, a specialized contrast medium—such as air bubbles, foam, or microbubble contrast—is introduced into the uterus. This allows visualization of the uterine lining and the flow of the contrast into the fallopian tubes, helping determine whether the tubes are open or blocked.
Common variations include HyCoSy (Hysterosalpingo-Contrast Sonography) and Foam Sonography.
When Is This Procedure Needed?
It is often recommended for:
- Infertility evaluation, especially to check for blocked fallopian tubes.
- Investigation of recurrent pregnancy loss.
- Assessment of uterine abnormalities, such as fibroids, adhesions, or polyps.
- Pre-treatment evaluation before IUI or IVF.
Procedure Overview
- Timing – Performed after menstruation but before ovulation to avoid disrupting an early pregnancy.
- Catheter Placement – A thin catheter is inserted into the cervix.
- Contrast Infusion – A sterile contrast medium (foam or microbubbles) is introduced into the uterine cavity.
- Ultrasound Imaging – A transvaginal ultrasound is performed while the contrast highlights the uterine cavity and flows into the fallopian tubes.
- Tubal Patency Check – If contrast passes into the abdominal cavity, the fallopian tubes are confirmed to be open.
Benefits
- Evaluates both uterine structure and tubal patency in one procedure.
- No ionizing radiation (unlike HSG).
- Typically less discomfort than HSG.
- Immediate results available during the ultrasound.
Risks & Considerations
- Mild cramping, bloating, or spotting after the procedure.
- Rare allergic reaction to contrast medium.
- Not suitable if pregnancy is suspected or pelvic infection is present.