Sono HSG, also called sonographic hysterosalpingogram, is a transvaginal ultrasound technique that involves assessment of fallopian tube patency with a mixture of air and saline delivered through an intrauterine catheter, as well as detection of abnormalities of the uterus.
Sono HSG is an accurate test for diagnosing tubal occlusion and performs similarly to a fluoroscopic HSG. Sono HSG should replace fluoroscopic HSG*
in the initial workup of subfertile couples because it also allows for visualization of the ovaries and myometrium, better sensitivity and specificity for the diagnosis of uterine cavity abnormalities, absence of radiation and risk of iodine allergy, while being comparable for patient tolerability. An economic study comparing cost-utility of Sono HSG and fluoroscopic HSG would add an interesting perspective to these considerations.
*S. Maheux-Lacroix et al. Hum Reprod 2014;29(5):953-63.
S. Maheux-Lacroix et al. Hum Reprod 2014;29(5):953-63.
Saunders RD, Shwayder JM, Nakajima ST. Fertil Sterili 2011;95:2171–79.
Using saline and air as a contrast for sonographic imaging of the fallopian tubes was found to be highly concordant to laparoscopic chromopertubation (LC) and fluoroscopic hysterosalpingography (fluoroscopic HSG) as evidenced by the studies below.
Sono HSG Compared to LC |
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Number of Tubes | Sensitivity (%) | Specificity (%) | Concordance (%) | ||||
Allahbadia Fertility and Sterility. 1992;58(5):901-907. | 134 | Not Reported | 94 | ||||
Heikkinen et al. Fertility and Sterility. 1995;64(2):293-298. | 61 | 82 | 86 | 85 | |||
Volpi et al. Ultrasound Obstetrics Gynecology. 1996;7:43-48. | 56 | 85 | 92 | 89 | |||
Spalding et al. Human Reproduction. 1997;12(11):2461-2464. | 29 | 63 | 100 | 90 | |||
Inki et al. Acta Obstetricia et Gynecologica Scandinavica. 1998;77:978-982. | 53 | 90 | 83 | 89 | |||
Jeanty et al. Journal Ultrasound Medicine. 2000;19:519-527. | 29 | 86 | 77 | 79 | |||
Exacoustos et al. The Journal of the American Association of Gynecologic Laparoscopists. 2003;10(3):367-372. | 30 | 75 | 91 | 87 | |||
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Sono HSG Compared to Fluoroscopic HSG |
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Number of Tubes | Sensitivity (%) | Specificity (%) | Concordance (%) | ||||
Allahbadia Fertility and Sterility. 1992;58(5):901-907. | 134 | Not Reported | 88 | ||||
Chenia et al. The British Journal of Radiology. 1997;70:833-836. | 142 | Not Reported | 88 | ||||
Spalding et al. Ultrasound Obstetrics Gynecology. 1999;14:205-209. | 31 | 50 | 97 | 94 | |||
Exacoustos et al. The Journal of the American Association of Gynecologic Laparoscopists. 2003;10(3):367-372. | 67 | 80 | 94 | 90 |
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Sono HSG is being used by hospitals and physicians as an alternative test to the fluoroscopic HSG
New ultrasound procedure can identify blockages in fallopian tubes.
You could have blockage in your fallopian tubes.
Using Sono HSG, patency can be tested with minimal discomfort to the patient.
To diagnose the cause of infertility, experts at the NYU Langone Fertility Center may perform several different tests.