1. Sonohysterography (SHG) in infertility
Sonohysterography (SHG) in infertility. A: Diagram of SHG using balloon-tipped catheter. The balloon is filled with saline and then retracted into the distal internal cervical os to prohibit reflux and obtain maximal distention. (Drawing used with permission from Paul Gross, MS.) B: Sonohysterography shows multiple polyps. C: Hysteroscopic view of multiple polyps seen in (B). D: Sonohysterography showing adhesion appearing as echogenic interface crossing the lumen. E: Hysteroscopic view of adhesion in patient in (D). (Used with permission from Esther Eisenberg, MD.) F: Initial transvaginal sonogram of patient before SHG. The endometrium (between cursors) is slightly irregular in this patient who has a history of several miscarriages. G: After saline distention, there is mild irregularity of the endometrium in the fundus. H: Same patient as in (F) and (G), with more distention confirming slightly in the irregular fundal endometrium. I: Hysteroscopic images of patient in (F-H), showing “heaped up” endometrium fundal area. J: Sonohysterography showing a submucosal fibroid (between cursors). K: Hysteroscopic view of patient in (J) showing submucosal fibroid. L: Sonohysterography showing double lumina of bicornuate uterus. Three-dimensional US would be helpful in distinguishing a bicornuate from a septated uterus. Note the fundal cleft. M: Sonohysterography in an infertility patient showing a fundal polyp. N, O: Transvaginal color Doppler sonogram of patient in (M) showing vascular pedicle of the polyp in long (N) and short (O) axes.
Source: Transvaginal Sonography in Gynecologic Infertility, Fleischer's Sonography in Obstetrics and Gynecology: Textbook and Teaching Cases, 8e
Citation: Fleischer AC, Abramowicz JS, Gonçalves LF, Manning FA, Monteagudo A, Timor IE, Toy EC. Fleischer's Sonography in Obstetrics and Gynecology: Textbook and Teaching Cases, 8e; 2017 Available at: Accessed: December 24, 2017
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