Which Fertility Test Is Best?

Getting to the root cause of infertility often requires specialized tests. Hysterosalpingogram (HSG) and sonohysterogram (SHG) both evaluate the uterus and fallopian tubes. Each test serves a specific purpose, helping doctors identify potential obstacles to conception. While both procedures provide valuable insights, slight differences in technique and results exist. Choosing the right test depends on fertility history and diagnostic needs.

Considering HSG

A hysterosalpingogram involves injecting contrast dye into the uterus. A fluoroscope, a specialized X-ray machine, tracks the movement of the dye. If the tubes are open, the dye flows freely into the abdominal cavity. If there is a blockage, the dye will be prevented from passing through. The doctor can then identify the blockage and determine whether removal is possible. In some cases, the procedure temporarily improves fertility by clearing minor obstructions.

A different approach with SHG

Unlike HSG, a sonohysterogram test uses ultrasound instead of an x-ray. A sterile saline solution expands the uterus for more precise imaging. This method is primarily used to evaluate the shape and structure of the uterus, helping doctors assess abnormalities like fibroids, polyps, or adhesions. While SHG does not evaluate fallopian tube blockages, the procedure provides excellent uterine detail. Many fertility specialists use this option to detect structural concerns before recommending additional testing.

Comparing comfort and risks

When deciding between HSG and SHG, many women may wonder if these procedures are uncomfortable or painful. A hysterosalpingogram often causes cramping due to the dye moving through the tubes. Over-the-counter pain medications can help the patient feel more comfortable. A sonohysterogram is typically gentler, with most patients experiencing only mild pressure. Both tests carry minimal risks, but HSG may pose a slight chance of infection or an allergic reaction to the dye. A fertility specialist can help determine the most appropriate choice based on individual circumstances.

Choosing based on fertility goals

A complete medical history and reproductive goals are crucial in selecting the proper test. An HSG procedure is typically recommended for women undergoing in vitro fertilization (IVF) or individuals trying to confirm tubal health. On the other hand, SHG is ideal for diagnosing uterine issues that may affect implantation. In many cases, doctors use both tests together for a comprehensive evaluation before proceeding with IVF or other fertility treatments.

Next steps after testing

Results from HSG and SHG procedures will be used to guide future fertility decisions. If an HSG reveals a blockage, further interventions may be necessary before proceeding with IVF. Surgery may be considered if SHG findings show uterine abnormalities that can impact embryo implantation. A detailed discussion of test results, next steps, and overall fertility goals should take place with a healthcare provider to ensure a successful pregnancy.