Hysterosalpingography (HSG)

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Hysterosalpingography (HSG)

Sono-HSG (sonohysterosalpingography, HyCoSy) is a minimally invasive ultrasound examination using contrast to assess the uterine cavity and the patency of the fallopian tubes - without X-ray exposure. It is an important step in the infertility workup and in planning further treatment.

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What is Sono HSG?

A diagnostic and therapeutic test in which, with the help of ultrasound and a contrast agent, the uterine cavity and the patency of the fallopian tubes are assessed. A thin tube (a catheter) is gently introduced through the cervix, through which the contrast is applied into the uterine cavity.

At the same time the gynaecologist monitors by ultrasound how the contrast fills the uterine cavity, the passage of the contrast through the fallopian tubes and its exit at the ends of the fallopian tubes into the abdominal cavity. This provides information about the patency of the fallopian tubes and any abnormalities in the uterine cavity (polyps, septa, adhesions) that can hinder implantation and the achievement of pregnancy.

Key features of the fallopian tube patency test?

Assessment of fallopian tube patency without exposure to X-ray radiation
Insight into the shape and cavity of the uterus in real time
A minimally invasive test performed on an outpatient basis
Important information for planning natural conception or assisted reproduction procedures

What are the benefits of the Sono HSG test?

No X-ray radiation

Unlike the classic X-ray test, Sono HSG uses ultrasound and contrast, so there is no exposure to ionising radiation – which is particularly important for patients planning a pregnancy.

Diagnosis in real time

The doctor sees the passage of contrast through the fallopian tubes and the appearance of the uterine cavity in real time, and can immediately share the first impression of the findings and the rough options with you.

A minimally invasive, outpatient method

The procedure is performed in outpatient conditions, without the need for hospitalisation. Most patients return to their usual activities the same or the next day after the test.

Indications and expected results

Sono-HSG is one of the key tests in the work-up of infertility, but also in assessing anatomical causes of difficult conception or recurrent miscarriages.

The most common indications

infertility of unknown cause
suspicion of blocked or partially patent fallopian tubes
suspicion of uterine anomalies (septa, bicornuate uterus, etc.)
suspicion of polyps, adhesions or scars in the uterine cavity

What can you expect?

The procedure itself usually lasts 10-20 min. With preparation and a short stay after the examination, you will spend a total of 30-60 min at the polyclinic.

Most women feel mild to moderate discomfort, similar to menstrual cramps, especially at the moment the contrast is injected. The pain is short-lived and passes quickly. If needed, a mild analgesic can be taken before the procedure. It is most often performed after the end of menstruation (between the 6th and 12th day of the cycle) in order to rule out the possibility of pregnancy.

The aim is to check whether the fallopian tubes are patent or blocked, to detect any abnormalities in the uterine cavity, to give a clearer picture of the possible causes of difficult conception and to help choose the most appropriate further approach - whether it is natural conception, insemination or the IVF procedure.

After the test, the doctor goes through the findings with you and explains what they mean for your pregnancy plans and potential assisted reproduction procedures.

What does the procedure look like - step by step

1. Conversation and brief preparation

The doctor goes through your medical history, earlier findings (ultrasound, hormones, any procedures) and explains the course of the test.

2. Gynaecological examination and placement of the catheter

In the gynaecological position a speculum is placed, the area of the cervix is cleaned and a thin tube (a catheter) is gently introduced through the cervical canal.

3. Application of contrast under ultrasound control

Under ultrasound control, the contrast agent is slowly applied into the uterine cavity. The doctor monitors the filling of the uterus and the passage of contrast through the fallopian tubes towards the abdominal cavity.

4. Assessment of the findings and a plan for the next steps

Immediately after the test you receive the first impression of the findings, and shortly afterwards a written report with a recommendation - continuing natural attempts, an assisted reproduction work-up or additional tests if needed.

The whole procedure usually takes a short time, and most patients tolerate it with mild, short-lived discomfort similar to menstrual cramps.

Preparing for Sono HSG

Preparation is simple, but it is important to follow the basic instructions so that the test is as reliable and safe as possible.

planning the test in the first half of the cycle, after the end of menstruation (most often between the 6th and 12th day of the cycle)
that you do not have heavy bleeding on the day of the test
avoiding sexual intercourse for a few days before the test, as instructed by the doctor
avoiding vaginal pessaries, douching and local preparations immediately before the test (unless explicitly recommended)
bringing all earlier findings (ultrasound, laboratory, previous operations, assisted reproduction documentation)

Note: You receive precise instructions (the exact day of the cycle, whether you may take your morning medication, whether you need special laboratory tests before the test) from our team when arranging the appointment, tailored to your situation and the planned further treatment.

Recovery after the procedure

Most patients can resume their usual daily activities immediately after Sono-HSG. Nevertheless, mild and short-lived symptoms are possible.

What can you expect after the examination?

mild discomfort or cramps in the lower abdomen, similar to menstrual pain
scant bleeding or brownish discharge for a day or two after the examination
the need to use sanitary pads instead of tampons for a short time

How to act after Sono-HSG?

use sanitary pads rather than tampons while bleeding or discharge lasts
avoid sexual intercourse for a few days, as advised by your doctor
avoid vaginal pessaries and douching, unless specifically recommended
rest if you feel tired or experience stronger discomfort, and if necessary take a mild analgesic that you usually use for menstrual pain (unless agreed otherwise)

When should you contact us sooner than planned?

Heavier, unusual bleeding
Intense pain in the lower abdomen that does not subside
Raised body temperature
Foul-smelling discharge

In such situations contact us as soon as possible, and if you are not sure whether it is needed immediately, please call — together we will decide on the next step.

Why choose Cito Polyclinic for Sono HSG?

When choosing where to have the fallopian tube patency test, what matters is the experience of the team, the quality of the ultrasound equipment and the way you are guided through the whole diagnostic process - especially if you are undergoing infertility treatment.

Sono HSG is performed by an experienced gynaecologist

The procedure is performed by an expert gynaecologist with many years of experience, who guides you through the whole examination. This provides greater safety, trust and an understanding of the next steps.

Modern ultrasound devices and contrast

The use of modern ultrasound technology and appropriate contrast agents allows a high-quality view of the fallopian tubes and the uterine cavity, with minimal discomfort.

An individualised plan after the test

After the procedure you are not left alone with the findings. The doctor goes through the results with you and proposes a realistic, individualised plan: continuing natural attempts, insemination or IVF.

An organised patient journey in one place

If needed, all further tests and treatment (hormonal work-up, insemination, IVF/ICSI) can be arranged in the same centre, with clearly defined steps and minimal waiting.

Price of the fallopian tube patency test - Sono HSG

The price of the test is 200 EUR. The price includes performing the test with contrast, an ultrasound assessment of the uterine cavity and tubal patency, and a written report with recommendations for further steps.

Before the test itself, our team will clearly explain to you everything that is included in the price, whether there is a need for additional tests and how the Sono-HSG fits into your overall infertility treatment plan.

You can get the exact price of the procedure and the first available appointment straight away by calling +385 21 457 800 or by sending a message via the contact form.

View the full price list

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