Saline Sonography (SIS) & HyCoSy: Checking the Uterus and Tubes
Reading time: about 7 minutes. This article is educational and does not replace an individual consultation.
When investigating fertility or abnormal bleeding, doctors sometimes need a clearer view of the inside of the uterus and the fallopian tubes than a standard scan provides. Two office-based ultrasound tests — saline sonography (SIS) and HyCoSy — do exactly this, without radiation. This article explains what they are and when they help.
Who this article is for
This is for women in Ahmedabad and Gujarat undergoing fertility evaluation or investigation of bleeding, who have been offered one of these tests.
What these tests are
Both use ultrasound with a small amount of fluid to improve the view:
- Saline sonography (SIS), or sonohysterography, gently instils sterile saline into the uterine cavity during an ultrasound, outlining the cavity walls to reveal polyps, fibroids bulging into the cavity, or adhesions.
- HyCoSy uses a special contrast to assess whether the fallopian tubes are open, as part of a fertility work-up — checking tubal patency without X-rays.
Both are typically quick, office-based procedures performed without general anaesthesia [Source: ISUOG guidance on saline infusion sonohysterography].
When SIS is useful
SIS helps clarify findings within the uterine cavity that a standard scan suggests but cannot fully define — for example to investigate abnormal bleeding, recurrent miscarriage, or before certain fertility treatments, where a polyp or cavity-distorting fibroid would change the plan [Source: ISUOG guidance].
When HyCoSy is useful
HyCoSy is used in fertility evaluation to check whether the fallopian tubes are open, since blocked tubes are an important and treatable cause of difficulty conceiving. It offers a radiation-free alternative to the traditional X-ray tubal test in suitable women [Source: NICE Guideline CG156, Fertility problems].
What to expect
These tests are usually done in the first half of the menstrual cycle, after a period has finished and pregnancy is excluded. You may feel some cramping similar to period pain during the procedure, which is usually brief. Simple pain relief beforehand can help, and most women return to normal activity the same day.
Advantages over older tests
- No radiation, unlike X-ray-based tubal testing
- Office-based and quick, usually without anaesthesia
- Real-time ultrasound view of the cavity and, with HyCoSy, the tubes
What to ask
- Which test do I need, and what question will it answer?
- When in my cycle should it be done?
- What pain relief can I take beforehand?
- How will the result change my plan?
Advanced ultrasound in Ahmedabad
Office-based uterine and tubal assessment can spare women more invasive or radiation-based tests. Balaji Horizon Women’s Hospital, on Science City Road in Ahmedabad, offers saline sonography and tubal assessment as part of thorough, radiation-conscious fertility and gynaecological evaluation.
When to seek advice
If you are being investigated for fertility difficulty, recurrent miscarriage, or abnormal bleeding, ask whether an office-based ultrasound assessment of the cavity or tubes would clarify your situation [Source: NICE Guideline CG156].
A note on next steps
For radiation-free uterine and tubal assessment, our team can help. Read more on our diagnostic ultrasound and fertility evaluation pages.
Frequently asked questions
What is the difference between SIS and HyCoSy?
SIS uses saline to outline the inside of the uterus and detect polyps, fibroids, or adhesions in the cavity. HyCoSy uses a contrast to check whether the fallopian tubes are open, as part of a fertility work-up. They answer different questions and are sometimes done together [Source: ISUOG guidance].
Is the procedure painful?
You may feel cramping similar to period pain during the test, which is usually brief. Simple pain relief beforehand can help, and most women return to normal activity the same day.
Is it better than an X-ray tubal test?
HyCoSy offers a radiation-free alternative to the traditional X-ray tubal test and can be done in the office. Which test suits you depends on your situation; your specialist will advise [Source: NICE Guideline CG156].
When in my cycle is it done?
Usually in the first half of the cycle, after your period has finished and once pregnancy has been excluded, to give the clearest view and avoid disturbing an early pregnancy.
Do I need anaesthesia?
Generally no. These are quick, office-based procedures usually performed without general anaesthesia, though simple pain relief beforehand is often recommended.
Disclaimer: This article is for educational purposes only and does not replace a consultation with a qualified specialist.
