Saline Sonohysterogram “Water Ultrasound”

Sonohysterogram is used to examine the uterine cavity for abnormalities prior to IVF treatments. Of all the articles, blog posts and information I’ve read over the past few years, I had never heard of this procedure. When I spoke with my nurse last week I let her know that Hubby and I want to move forward with IVF as soon as possible, if our 3rd IUI is unsuccessful. She told me to set up an appointment for a “water ultrasound”.

The saline sonohysterogram is typically performed between cycle day 6 to 12, after menstruation has completed, but before ovulation, its best diagnostic quality when the lining is thin. The procedure uses ultrasound technology while using saline through a catheter to inflate the uterus. This makes it much more effective at diagnosing any abnormalities. When only ultrasound is used its much like looking at a deflated balloon, when saline is added to open up the uterus the doctor is able to see things that may have been well hidden like polyps, fibroids, scar tissue, septum or bicornuate uterus.

I was brought back into the exam room, the assistant had me verify my name on the ultrasound screen and no allergies to latex, when the first day of my period was. She had me empty my bladder. The procedure starts as many others do, naked from the waist down & feet up in stirrups. The APRN inserts a speculum, cleans the cervix & inserts the catheter. I felt moderately uncomfortable/pain when the catheter was inserted. A balloon is inflated to allow the saline to go in. Saline is injected into the catheter and down into the uterus. The nurse also has the internal ultrasound on to watch the inflation of the uterus.  The nurse took many pictures of the uterus and also examined the ovaries and counted follicles. During the procedure they were letting me know what they were looking at and explained certain things to me. After the procedure everything is removed and the saline leaks out. They gave me a paper towel and panty liner.

In my experience the insertion of the catheter/balloon was slightly painful, but not unbearable. The injection of the saline also felt uncomfortable/burning sensation. It was tolerable, but certainly not comfortable. The nurse was not able to get the catheter into my uterus. She tried to reposition but came to the same conclusion. The catheter would go in, but then there was almost like a corner that made it impossible for the catheter to pass as it would just hit into my tissue causing pain/cramping.

They did not seem concerned at all, and she said for this procedure “It doesn’t matter” because the saline was inflating the uterus. This was also a Mock Transfer for IVF so she wrote down the measurement to the top of my uterus. They also noticed a flap of tissue in my uterus, she stated that it doesn’t look like scar tissue because it was moving as the saline was injected. She thinks its soft tissue caused by the catheter insertion. The doctor will examine the findings and call me today.

I felt very sad & frustrated leaving the office, someone (not infertile) texted me a photo of their BFP after trying for like 3 months. Needless to say I cried the whole way home.



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