Hysterosalpingography (HSG) and
Saline Infusion Sonohysterography (SIS) are two tests employed to investigate
the female anatomy of the genital system, often in the setting of infertile
couples or abnormal vaginal bleeding. Both techniques entail the introduction
of fluid to the uterus to visualise its cavity and fallopian tubes during HSG.
On HSG, a radiopaque dye is used with X-ray imaging, whereas on SIS, sterile
saline is also used with ultrasound. The tests will aid in estimating
structural defects that can obstruct conception or lead to gynaecological
presentation.
Key indications for performing HSG or SIS:
Fertility assessment: Both of these procedures are key indications in this area. HSG plays a vital role in measuring the patency of fallopian tubes to understand whether the fallopian tubes are open or blocked, which is essential in natural conception. SIS, however, is more impressive in visualising the uterine cavity to identify minor abnormalities that may hinder embryo implantation.
Recurrent Miscarriage: If a woman has had multiple miscarriages, these tests will be able to diagnose structural abnormalities in the uterus, like polyps, fibroids, intrauterine adhesions (scar tissue), or congenital disabilities (e.g. septate uterus) that may be contributing factors.
Key indications for performing HSG or SIS:
Abnormal Uterine Bleeding: Ongoing or abnormal bleeding is an indicator of abnormalities of the uterus. The distention of the uterine cavity also makes SIS a method of choice in diagnosing endometrial polyps or the more common submucosal fibroids, often a source of such bleeding.
Pre-IVF Screening: Before getting IVF done, one should be careful to make the uterus well-prepared to receive embryos. HSG or SIS may also be used to eliminate uterine or tubal problems that could interfere with the success of IVF.
Effects of undergoing HSG or SIS:
Weird Diagnosis of Uterine and Tubal Pathology:These tests provide detailed images to diagnose many conditions related to the reproductive system, such as clogged fallopian tubes (HSG) to endometrial polyps, fibroids and adhesions inside the uterine (SIS) cavity, and prescribe proper treatment.
Possible Therapeutic Value (HSG):The pressure of the contrast material (could flush minor blockages out or adhesions of the fallopian tubes) during an HSG may make it easier to conceive naturally in the months after the procedure.
Recommendations on Future Management:The results of HSG or SIS determine the course of the next medical or surgical practice. In identifying a polyp, hysteroscopy (direct visual inspection and removal) is a possible solution. In case of blocked tubes, the next approach may be IVF.
Patient Reassurance and Decreased Anxiety:In many patients, the identification of the cause behind their fertility problems or their symptoms, even in the case of a structural aetiology, could constitute an essential step toward a resolution and decreasing the emotional load of not having answers.