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What solution is used for a sonohystergram?

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Posted on Mon, 11 May 2015
Question: What solution is used for a sonohystergram?
Medical History - Phlebitis, varicose veins, light heart mummur
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Answered by Dr. Manisha Jain (20 minutes later)
Brief Answer:
ultrasound gel is needed

Detailed Answer:
Hello dear, thanks for trusting health careagic.
Specific gel is available in market easily.
It is basically a conduit for the probe of the ultrasound scan to establish a proper medium for the ultrasonic waves which is then evaluated real time.
Just let me know the quantity needed so that I van get you the desired product.
Regards
Dr Manisha
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Follow up: Dr. Manisha Jain (5 hours later)
Hello Dr. XXXXXXX

The solution that was used in my sonohysterogram was saline solution.

How much of this saline solution is normally administered into the uterus when this test is performed? An approximate amount, please.

Also, what is the reason for the cervix being closed and for it to be poked so that the catheter for the sonohyst may be inserted?

Thank you.
doctor
Answered by Dr. Manisha Jain (15 hours later)
Brief Answer:
15-30 cc

Detailed Answer:
Hi sir, sorry for delay in response.
Usually 15-30cc of saline is pushed through the catheter and amount increases in case some difficulty is encountered in assessment of the tubal patency.
Usually cervix is closed in all women who haven't given birth to a baby via vaginal route.
But in some women (around 10-15%) it stays closed very tightly and thus catheter placement is difficult and cervical manipulation is needed for the same.
So nothing to worry about it and also I would like to know the report of sonogram so that I can advice you better.
Take care.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Manisha Jain (2 hours later)
Dear Dr.,

Thank you. I don't know those measurements, but the doctor told me about 1 teaspoonful was put into my uterus, and I thought that was strange and very little. I am not sure how many cc that would be.

My biopsy came back with Final Diagnosis as "Uterus/Endometrial Biopsy" - "Inactive/atrophic endometrial tissue." Is this good? My doctor is not in, but these are the written results that were mailed to me.

Here are the results from sonohysterogram: NO POLYPS OR SUBMUCOSAL MYOMAS NOTED.

Right Ovary: Visible.
Right Ovary: size 29mm x 13mm x 18mm Volume: 3.6 ml.
Comments: FOLLICLE NOTED = 20 x 9 x 12MM

Left Ovary: visible.
Left Ovary size: 21mm x 19mm x 11mm. Volume 2.3 ml

Method: transvaginal ultrasound with Saline.

UTERUS: ateverted.
Size: Long 64mm Anterio-posterior 39mm. Transverse 47mm Vol. 61.4 ml.
Cervix: Cervical length 31mm
Fibroids: Fibroid 1: Size: 13mm x 12mm. Position: fundus
Endometrium: endometrium clearly visualized after saline instillation into the cavity.
Endometrium thickness (single layer): anteriod: 1.1mm, posterior: 1.8mm.

Please let me know if this is good or not. And, it looks like I have a fibroid, but no one told me over the phone. I have the written report.

Thank you.
doctor
Answered by Dr. Manisha Jain (21 minutes later)
Brief Answer:
nothing to worry as per reports

Detailed Answer:
You are most welcome dear.
One teaspoon is 5-7 cc so it is good that only this amount of fluid gave the desired information.
This means that the fallopian tubes are nicely patent and report is also consistent with that.
Atrophic endometrium is not a good report so I would like to know full biopsy report and day of her cycle when biopsy was taken.
Fibroid is very small and that too at fundus of uterus so nothing to worry.
All in all your report is good except biopsy report.
So please tell me the day of biopsy and elaborate report.
Waiting for your response.
Regards
Dr Manisha
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Manisha Jain (1 hour later)
Dear Dr. XXXXXXX

Hello again. The date of my Uterus/Endometrial Biopsy was performed on March 30, 2015. The last period I had was February 26, 2015 and it lasted until March 9, 2015. Very little blood on March 9, 2015 and gone on March 10, 2015.

That is all the information that my gyn/ob received from the pathologist. The written report from Surgical Pathology Report states:

Final Diagnosis
Uterus, endometrial biopsy
-Inactive/atrophic endometrial tissue.

Gross Description:
The specimen is received in formalin and the specimen container is labeled: Endometrial. It consists of a 1.0 cm aggregate of soft, tan-pink, mucoid material. Entirely submitted. One cassette.

That is the only information that I have on this.

Please let me know why you believe that this result is not good.

Thank you.
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Follow up: Dr. Manisha Jain (7 hours later)
Hello,

I am awaiting your reply, please. I gave you the answer (please see above note I sent earlier today) and all the information I have. Please let me know why you believe the biopsy is not a good report.

Also, can a dr. actually get such a clear image with on 1 tsp. of the saline? I was a little concerned about that.

Thank you.
doctor
Answered by Dr. Manisha Jain (11 hours later)
Brief Answer:
nothing to worry as yet except poor biopsy report

Detailed Answer:
I have read all your report and it is not a good one because according to the day of her cycle the report should be secretory phase endometrium but it is given as atrophic one.
The reasons for the same can be either very irregular periods and thus lack of ovulation or just a bad storage and preservation of the sample.
So now you should have a proper follicular study along with ovulation induction drugs.
Also get the following tests for your wife - TSH, Prolactin levels and blood sugar levels and get your semen analysis.
Take all the reports along while going for follicular study.
Clear image can be obtained by this small saline volume but for testing patency of fallopian tubes usually amount is a little large.
So discuss with your radiologist the status of tubal patency and that if at all it was tested or not.
There is nothing to worry all in all as yet because there is no major problem detected so far except the poor biopsy report.
Also take care of the following measures to enhance the chances of conception -
1) try to keep a pillow beneath her buttocks after sex so that gravitational force keeps the semen inside her vagina for a longer time.
2) she should not get up for at least 20-25 minutes
3) try conventional position of sex female lying down on bed
4) maximum chances of conception are in day 10-18 of the cycle in case she has regular cycles.
I hope these measures will help you in conception in near future.
I basically practice infertility so in case you have any questions in future I will be glad to help.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Manisha Jain

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Practicing since :2007

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What solution is used for a sonohystergram?

Brief Answer: ultrasound gel is needed Detailed Answer: Hello dear, thanks for trusting health careagic. Specific gel is available in market easily. It is basically a conduit for the probe of the ultrasound scan to establish a proper medium for the ultrasonic waves which is then evaluated real time. Just let me know the quantity needed so that I van get you the desired product. Regards Dr Manisha