Sonohysterogram (SHG)

An ultrasound exam of your uterus and fallopian tubes

The sonohysterogram (SHG or “sono”) is an ultrasound examination that gives considerable information about your uterus and fallopian tubes, without the use of X-rays, X-ray dye or an anesthetic. It has become the “gold standard” in assessing the causes of uterine bleeding and infertility.

Reasons for this test are numerous and may include irregular vaginal bleeding, infertility, miscarriages, any suspected abnormalities of the uterus, or a preliminary evaluation for in vitro fertilization. You will have preliminary scans of your pelvis before the test.

Booking your appointments

The sono is made up of two separate appointments. Part B cannot be completed without completing Part A.

Part A: pelvic and transvaginal ultrasound (full bladder)

Appointments are available Monday to Friday.

  1. When you get day 1 of your period (full flow and bright red bleeding), book this between day 2 and 5 of your cycle. You can book this in your patient app. If you need to reschedule or cancel, please contact your Primary Care Team.
  2. Drink 4–5 glasses of water one hour before your appointment so you have a full bladder.
  3. This is performed by the ultrasound sonographer and takes 15–20 minutes. When it’s done, you may leave the clinic. If you have not yet picked up your antibiotic for the sonohysterogram, please check in at the front desk.
  4. After your ultrasound appointment, go to the front desk to have your sono appointment booked between day 5 and 10 of your cycle.

Part B: sonohysterogram with antibiotics

Appointments are booked on Mondays, Tuesdays, Wednesdays and Thursdays at 1 pm, first come, first served.

  1. The ultrasound receptionist will book you in for this appointment when your Part A results are complete.
  2. This testing is typically performed between day 5 and 10 of your cycle.
  3. You will not need a full bladder for the SHG itself.
  4. Your physician has prescribed an antibiotic for you to take on the morning of your SHG appointment. It will be either doxycycline 200 mg taken orally as 1 dose, or azithromycin 1 g taken orally as 1 dose. You may be asked to take a longer course of antibiotics; if so, the nurse will contact you. Please take the antibiotics with food to avoid an upset stomach or nausea.
  5. Take 2 ibuprofen (Advil) one hour before your SHG appointment. This relaxes your uterus, tubes and muscles. As with any medication, do not take it if you are concerned about possible allergies. You may discuss this with the physician or nurse.
  6. Make sure you have eaten before the appointment.
  7. Please come in 10–15 minutes before your appointment to fill out a sono consent form.
  8. A pad or liner may be needed. This is normal and will resolve over the next day or so.
  9. This is performed by the physician with the ultrasound sonographer.

What to expect

While the procedure itself is usually quite quick, plan to be in the clinic for up to an hour. A thin catheter is placed through the cervix into the uterus. Normal saline (a salt water solution) is passed through the catheter so we can see the inside of the uterus and, if appropriate, a contrast solution is used to assess the fallopian tubes.

During the procedure you may feel some cramping as the saline goes in. Some patients have said there was slight discomfort when the catheter was placed; however, most patients tolerate it easily. After the test, you may resume your normal activities. Please bring a sanitary pad on the day of your appointment.

Side effects and complications

Procedure-related side effects and complications are uncommon and usually mild. These include pelvic pain (3.8%), vagal symptoms (3.5%), nausea (1%), fever (0.8%) and possible bleeding. If you are concerned, please follow up with your Primary Care Team.

If you have any questions or comments, please contact your Primary Care Team.