Hysterosalpingography (HSG) is a method of examining patency of Fallopian tubes. For a woman to conceive, tubes must be intact. As they are of very fine structures, if there is no damage, they are not visible by ultrasound. HSG is normally performed radiologically. It almost never gives false positive results, but due to the usage of x-rays, it has almost been abandoned. The procedure is painful and can cause infection in pelvic region, but the percentage of pregnancies after the procedure is nearly 70%, probably because microscopic adhesions are torn.
Recently HSG is being done with ultrasound, a so-called hysterosonosalpingography (sono HSG). Sono HSG is a method introduced into clinical practices in 1984, at first using only conventional ultrasound and later using the contrasts and color Doppler ultrasound. It is used to determine morphology of cavum uteri (uterine cavity) and patency of Fallopian tubes. The cavity may become smaller due to various growth anomalies and pathological masses such as polyps and submucous myomas, as well as adhesions of different etiology. Doppler ultrasound was introduced here to examine patency of tubes as practice showed that when using only B mode there is little to say about potential pathology of tubes in case of their patency. Today these methods are used complementary and they have practically, in combination with HSC and LPSC, completely eliminated the need to use traditional radiological HSG. Sono HSG is a less invasive, less painful and cheaper method which can be used multiple times.