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What are the differences between hysterosalpingography and hysterosonosalpingography?

By Dra. Elisa Pérez Larrea (gynecologist).
Last Update: 11/26/2021

Both Hysterosalpingography (HSG) and Hysterosonosalpingography (SHSG) are outpatient procedures used to evaluate tubal patency or obstruction in patients with infertility, as well as endocavitary uterine pathology.

HSG involves viewing the passage of an iodinated contrast dye through the uterus and tubes using several pelvic radiographs, while SHSG involves monitoring the passage of a gel-foam using pelvic ultrasound. Both are well tolerated, although referred pain is less with SHSG.

SHSG also has the advantage of avoiding the use of ionizing radiation and the risk of allergies to iodine, since a gel-foam composed of hydroxypropylcellulose and glycerol is used, and allergic reactions to it are rare. Compared to HSG, SHSG also allows concomitant visualization of the ovaries and myometrium.

In recent years the SHSG technique has improved with the introduction of new contrast media, 3D ultrasound, use of color Doppler and better ultrasound resolution. At present, it seems that SHSG can replace HSG as the first-line method in the study of infertility, one of its main advantages being the direct and dynamic examination of the fallopian tubes.

Dra. Elisa Pérez Larrea
Dra. Elisa Pérez Larrea
MD, MSc
Gynecologist
Dr. Elisa Pérez Larrea is a graduate in Medicine and Surgery from the University of Zaragoza and a specialist in Obstetrics and Gynecology from the University of Oviedo. She also has a Master's degree in Human Reproduction from the Complutense University of Madrid.
Licence number: 203311163
Gynecologist. Dr. Elisa Pérez Larrea is a graduate in Medicine and Surgery from the University of Zaragoza and a specialist in Obstetrics and Gynecology from the University of Oviedo. She also has a Master's degree in Human Reproduction from the Complutense University of Madrid. Licence number: 203311163.