Sonohysterogram uterine

Normal test: The dark area within the uterus is the saline filling the uterine cavity. No abnormalities are seen

Abnormal test. The uterine cavity has an irregular outline consistent with endometrial polyps (outlined in red and marked by white arrows).

Tubal PatencyInfertility investigations have traditionally included x-ray hysterosalpingography (HSG) or laparoscopy for the assessment of tubal patency. Sonohysterography is an alternative technique.When tubal patency is evaluated, a balloon tipped catheter is required to appropriately distend the endometrial cavity and to force fluid out of the fallopian tubes into the cul-de-sac. The infused saline should be shaken in the syringe - the bubbles that result are easier to see passing through the fallopian tubes. Color Doppler assessment of the fallopian tubes has also been used to document tubal patency (Fig. 15). More recently, ultrasound contrast agents have been employed to assess tubal patency41.

Figure 15. Color Doppler illustration of right fallopian tube patency. Click for larger image.

In the presence of bilaterally occluded fallopian tubes, the uterine cavity will expand with only a limited instillation of saline and will not decompress. Patients will invariably complain of discomfort from the uterine pressure. The demonstration of true unilateral occlusion, in contrast to cornual spasm, cannot be determined during sonohysterography. The rapid egress of fluid through the fallopian tube with the least resistance can be interpreted as a unilateral occlusion42.

USG