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Saline Sonogram – A Simple Diagnostic Tool To Detect Uterine Abnormalities

A saline sonogram is a transvaginal ultrasound exam in which a sterile saline solution is gently pumped into the uterus. It is also known as a sonohysterogram.

It detects uterine abnormalities such as endometrial polyps, fibroids, and scarring.

Physical abnormalities, including blocked fallopian tubes and uterine abnormalities such as fibroids, polyps, scar tissue, and uterine septa, may all be structural causes of infertility.

If the fallopian tubes are clogged, sperm cannot fertilize an egg, and eggs cannot migrate from the ovaries to the uterus.

An ectopic pregnancy occurs when a fertilized embryo cannot move via the fallopian tube into the uterus.

Uterine abnormalities may prevent a fertilized egg from implanting in the uterine lining.

A saline sonogram is one of the various methods for evaluating tubal and uterine abnormalities.

The saline solution distends the uterus and beautifully defines the uterine lining, providing greater information than traditional ultrasound.

This technique takes less than ten minutes and gives your doctor critical information about any impediments that may prevent an embryo from implanting in the uterus.

What Is A Saline Sonogram?

A Saline Sonogram is the most comprehensive examination of the uterine cavity.

Basic ultrasonography may reveal much about the uterine muscle/uterine wall and the ovaries.

Ultrasound transducers send out high-frequency sound waves, translated into electrical impulses that provide a moving picture of the body's interior on a screen.

Uterine fibroids, ovarian cysts, and normal ovarian follicles may all be readily identified with basic ultrasonography.

The uterine cavity is located in the center of the uterus. It is made up of fleshy tissue that is hormonally sensitive and may readily conceal polyps if a Saline Sonogram is not done.

The saline sonogram may also provide more specific information regarding the precise position of a fibroid, allowing doctors to evaluate if it will interfere with early pregnancy or whether it is just an innocent bystander enclosed entirely inside the uterine wall.

Indications For Saline Sonogram Test

A saline sonogram test may be ordered for a variety of reasons, including:

  • Menstrual irregularities (extremely heavy or unusually light periods)
  • Menstrual cramps that aren't typical
  • Before IVF treatment (to confirm there are no uterine problems that may interfere with embryo implantation)
  • Infertility
  • Mid-cycle observation
  • Pelvic discomfort or pressure
  • Bleeding after menopause
  • Recurrent miscarriage (two or more miscarriages in a row)

A saline sonogram examines and detects the uterine shape and congenital uterine anomalies (such as a uterine septum, which occurs when tissue separates the uterus), polyps (non-cancerous growths) on the uterine lining, and fibroids (especially if they are protruding into the uterine cavity).

The test may also assess uterine adhesions (scar tissue), aberrant endometrial tissue growths (cancerous or not), and the general thickness or thinness of the uterine wall and endometrium.

Benefits Of Saline Sonogram

  • The majority of ultrasonic scanning is noninvasive (no needles or injections).
  • An ultrasound exam may be unpleasant sometimes, but it should never be painful.
  • Ultrasound is more widely accessible, simple to use, and less costly than most other imaging techniques.
  • Ultrasound imaging is entirely safe and does not involve the use of radiation.
  • Soft tissues not appearing well on x-ray pictures are seen with ultrasound scanning.
  • Saline sonogram is a straightforward, minimally invasive treatment that most patients tolerate. There are generally few difficulties.
  • It is a quick treatment showing the uterus and endometrial lining.
  • Many uterine abnormalities that may be missed with standard transvaginal ultrasonography may be observed in great clarity with a saline sonogram.
  • Sonohysterography may help you avoid unnecessary surgery. It may also aid surgeons in the removal of all polyps and fibroids.

How To Prepare For Saline Sonogram?

There is no need for any prior preparation. The scan is most effective after your menstruation is over, on days 5-9 of your menstrual cycle.

As a result, scheduling your visit around your period dates is advisable.

Before the scan, you will be asked to use the restroom and empty your bladder. If you are wearing a tampon, it must be removed.

If your period ends and your bleeding is minimal, you may still undergo the scan.

A saline sonogram scan cannot be performed if you are pregnant or have a pelvic inflammatory illness.

If you have one of these conditions, you must notify your referring doctor or the facility where you get the scan.

Wear comfortable attire that allows easy access to the bottom half of your body.

How Is Saline Sonogram Performed?

You will be asked to undress from the waist down and may be required to wear a robe after emptying your bladder. After that, you will be instructed to lay down on an examination bed.

Before the SIS, a standard pelvic and transvaginal ultrasound may be performed (see InsideRadiology: Transvaginal ultrasound).

A speculum (a device that holds the vagina open for examination) is then placed into the vagina.

Through the speculum and into the uterus through the cervix, a soft catheter (a thin plastic tube) is softly inserted (the neck of the uterus).

While the catheter remains in the uterus, the speculum is withdrawn, and a transvaginal ultrasound transducer is introduced into the vagina.

The transducer is slightly bigger than a tampon and is precisely designed to fit comfortably inside the vaginal cavity.

For ease of insertion, a protective sterile probe cover is put over the transducer, and lubricating gel is applied.

A little quantity of saline (salt solution) is introduced into the uterine cavity through the catheter.

The transducer is then gently moved around during and after the saline injection to capture photos of the interior of the uterus.

The saline solution inside the uterus enables the uterine lining to be visualized on the ultrasound screen, revealing any endometrial abnormalities.

A doctor is doing an ultrasound of a patient
A doctor is doing an ultrasound of a patient

After Effects Of Saline Sonogram

There is a little trickle of fluid from the vagina after the scan. The saline solution that was put via the catheter is now draining.

It is often somewhat blood-colored which may last up to 24 hours. You may use a sanitary pad, but you should avoid tampons for the rest of the day.

Most people report feeling fine following the scan, with no side effects. Some people may have pelvic discomfort (similar to moderate period pain). However, this resolves within a few minutes to an hour and is very rare.

A tiny minority of people may have dizziness due to the catheter gently irritating the cervix. This usually disappears in a few minutes and has no adverse consequences.

You can usually drive home and continue regular activities, such as returning to work.

Uses Of Saline Sonogram

It is a valuable method for analyzing abnormal vaginal bleeding that cannot be explained medically and may be the consequence of uterine abnormalities such as:

  • Polyps
  • Fibroids
  • Atrophy of the endometrium
  • Endometrial adhesions (or scarring)
  • Cancerous lesions/masses
  • Congenital defects

Sonohysterography is also used to assess uterine anomalies in women with infertility or numerous miscarriages.

This is done in women who have undergone the procedure more than once.

Images obtained from a Doppler ultrasonography may assist the clinician in seeing and evaluating:

  • Impediments to the passage of blood (such as clots).
  • Circulation of blood in polyps, cancers, and other abnormalities.
  • Pelvic varicose veins as well as abdominal aortic aneurysms.

Risks And Complications Of Saline Sonogram Test

The saline sonogram procedure is a reasonably safe operation frequently carried out without incident. Serious problems are uncommon.

Pelvic infection is the most frequent significant consequence of saline sonograms.

However, this happens fewer than 1% of the time and generally occurs when a woman also has a fallopian tube blockage or infection.

Cramping, spotting, and vaginal discharge may also occur due to the saline sonogram.

Some women have cramps for many hours after the surgery. Before this test, taking an anti-inflammatory medicine such as ibuprofen is standard practice.

Before the treatment, some physicians may additionally prescribe more potent pain relievers and antibiotics.

Contact your doctor if you develop discomfort or fever within 1-2 days after the saline sonogram.

Interpreting Test Results

The sonohysterogram technician or doctor may or may not be able to give you the findings. You will most likely be scheduled for a follow-up appointment with your doctor shortly following the exam.

If the test results were normal, your doctor may:

  • Accept your future IVF cycle (if this was part of IVF preparation)
  • Create a fertility treatment plan based on your full fertility assessment findings partly found.
  • Request further testing.

If a sonohysterogram reveals abnormalities, the next step is determined partly by what the doctor discovered and your testing aim. If polyps or fibroids are found, your doctor will discuss the benefits and drawbacks of removing them. Polyps may be removed surgically via hysteroscopy. This is performed while under general anesthesia.

Small fibroids may also be removed surgically by hysteroscopy. On the other hand, larger ones may need laparoscopy (an outpatient operation) or even abdominal myomectomy (surgery that requires an overnight stay or two in the hospital.)

Sonohysterography may be used to identify the uterine septum. The uterine septum is formed when tissue that should not be there divides the uterus along the middle. This separation may be partial or complete, extending to the cervix. It may lead to infertility and several pregnancy losses. This is an uncommon congenital condition (you are born with it). However, it is treatable with surgery, most often a surgical hysteroscopy.

People Also Ask

What Should I Expect After A Saline Ultrasound?

Light bleeding and cramps may occur for a few days after the surgery.

For cramping, you may take an over-the-counter (OTC) pain treatment such as Motrin or Advil.

For a day or two, you may also leak salt water. You are permitted to wear a pad.

How Long Does A Saline Sonogram Take?

The complete process usually takes around 30 minutes.

Most of this time is spent scanning before and after the saline is injected into the uterus.

The real-time it takes to put the saline in is around 2-3 minutes.

What Is The Purpose Of A Saline Sonogram?

The uterus and the morphology of the uterine cavity are evaluated by saline infusion sonohysterography (SIS or SHG).

The uterus and endometrial (uterine lining) cavity are seen using ultrasonography and sterile fluid.

The ovaries are also seen during saline infusion sonohysterography.

The goal is to discover any anomalies.

Is Saline Sonogram Painful?

Unfortunately, a saline sonogram might induce pain and suffering depending on the procedure and anesthesia techniques used.

The technique may be painful due to the tenaculum gripping the cervix, movement of cannulas in the uterus, and saline distention of the uterine cavity.


A saline sonogram test is a highly safe operation, and complications are uncommon.

When the fluid is carefully put into the uterine cavity, you may experience pain.

The most prevalent consequence is a pelvic infection, which is uncommon.

Saline sonogram tests should not be conducted on pregnant women who think they are pregnant.

A saline sonogram should also be avoided in women with active pelvic infections.

About The Authors

Suleman Shah

Suleman Shah - Suleman Shah is a researcher and freelance writer. As a researcher, he has worked with MNS University of Agriculture, Multan (Pakistan) and Texas A & M University (USA). He regularly writes science articles and blogs for science news website immersse.com and open access publishers OA Publishing London and Scientific Times. He loves to keep himself updated on scientific developments and convert these developments into everyday language to update the readers about the developments in the scientific era. His primary research focus is Plant sciences, and he contributed to this field by publishing his research in scientific journals and presenting his work at many Conferences. Shah graduated from the University of Agriculture Faisalabad (Pakistan) and started his professional carrier with Jaffer Agro Services and later with the Agriculture Department of the Government of Pakistan. His research interest compelled and attracted him to proceed with his carrier in Plant sciences research. So, he started his Ph.D. in Soil Science at MNS University of Agriculture Multan (Pakistan). Later, he started working as a visiting scholar with Texas A&M University (USA). Shah’s experience with big Open Excess publishers like Springers, Frontiers, MDPI, etc., testified to his belief in Open Access as a barrier-removing mechanism between researchers and the readers of their research. Shah believes that Open Access is revolutionizing the publication process and benefitting research in all fields.

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