Sonohysterography vs HSG: Which Test Is Better for Checking Uterus Health?

If you are facing trouble conceiving or are planning fertility treatment, it is important to know how your uterus and fallopian tubes are doing. This article will help you understand why a test called sonohysterography (SHG) may be better than another test called hysterosalpingography (HSG) for checking your uterus. This can help you make better choices for your treatment.

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If it’s taking longer than you hoped to get pregnant, your doctor might suggest some gentle tests to see how they can support you. These tests check if your uterus and fallopian tubes are healthy. Two common tests are HSG and SHG. They both give useful information, but in different ways. Knowing the difference between these two tests can help you feel more prepared and make better choices for your fertility journey.

What Is HSG?

HSG stands for hysterosalpingography. It’s a special kind of X-ray. It helps the doctor see inside your body, including the shape of the uterus and whether the fallopian tubes are open.

How it is done:
  • A thin tube is placed in the cervix
  • A dye is put inside the uterus and tubes
  • X-rays are taken

What Is SHG?

SHG stands for sonohysterography. It uses sound waves instead of X-rays. A little bit of salty water is gently put into the womb. A vaginal ultrasound checks the inside of the uterus.

Why You Might Need These Tests

If you are, trying to get pregnant for a long time:

How SHG and HSG Are Different

Feature HSG SHG
Uses X-raysYesNo
Uses sound wavesNoYes
Uses dyeYesNo (uses saline)
Pain levelCan be painfulLess pain
RadiationYesNo
Can see fallopian tubesYesNo
Can see inside uterus clearlyNot very clearVery clear

What Doctors Found in Studies

According to medical studies: SHG finds problems in the uterus more often than HSG. SHG is more accurate for:

Benefits of SHG

  • Better accuracy: Finds more real issues
  • Less pain: Saline is gentler than dye
  • No radiation: Safer, especially if done many times
  • Good for uterus check: Helps doctors plan treatments like hysteroscopy better

When HSG May Still Be Needed

  • If your doctor wants to check if the fallopian tubes are open
  • To check if the dye moves freely into the abdomen

What You Should Do

  • Talk to your fertility doctor
  • Ask what test is better for your condition
  • Share your full medical history
  • Let your doctor know if you have pain or heavy bleeding during periods

Important to Remember

  • These tests should be done during the early part of your cycle (usually Day 5 to Day 11)
  • You must not be pregnant during the test
  • Mild cramping may happen after the test

Possible Side Effects

Both SHG and HSG are generally safe. But you might feel:
  • Cramps
  • Light spotting
  • Slight dizziness
If you have:
  • Heavy bleeding
  • Fever
  • Bad pain


Tips Before and After the Test

Before the test:
  • Try to schedule the test between Day 5 and Day 11 of your cycle (after your period ends).
  • Do a pregnancy test before the procedure to be safe.
  • Take a light meal before the test.
  • Wear loose, comfortable clothes.
  • Carry a sanitary pad with you in case of spotting.
  • If your periods are painful or make you feel nervous, it’s okay to talk to your doctor.
  • Ask your doctor if you can take a pain tablet before the test.
During the test:
  • Try to stay calm and breathe slowly.
  • Tell your doctor right away if you feel sharp pain.
After the test:
  • You may feel light cramps or spotting; this is normal.
  • Rest for a few hours if needed.
  • Avoid heavy exercise or intercourse for 1–2 days.
  • Drink water and eat something light.
  • Call your doctor if you get a fever, heavy bleeding, or severe pain.
Both SHG and HSG are helpful tests to find problems in the uterus. SHG gives a clearer picture of the inside of the uterus and causes less pain. HSG is still useful when the doctor needs to check your fallopian tubes. Your doctor will pick the best test for you, depending on what you need. Knowing a bit about these tests can help you feel braver and more ready for your fertility journey.
Whether you’re trying to conceive or navigating IVF, you’re not alone. Join our supportive communities to connect, share, and find strength with others on the same journey.

FAQs on Why Sonohysterography Might Be Better Than Hysterosalpingography to Check Uterus Health

  1. Is SHG painful?
    It may cause mild discomfort, but it is usually not very painful.
  2. Is it possible to detect blocked fallopian tubes using a sonohysterogram (SHG)?
    No, SHG mainly checks the uterus. HSG is better for tubes.
  3. Do I need to take any medicine before these tests?
    Some doctors suggest pain medicine. Always ask your doctor.
  4. Are there any risks?
    Risks are low. But infection or allergy to the dye (in HSG) is possible.
  5. How long do these tests take?
    Both tests usually take around 15 to 30 minutes to complete.
  6. Do I need rest after the test?
    You can return to normal work the same day, unless your doctor tells you otherwise.
How we reviewed this article
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