Hydrosonography - (Aqua-scan Saline Infusion Sonography)
Hydrosonography is a specialized ultrasound examination used in the investigation of female fertility. It allows detailed evaluation of the uterine cavity and helps identify anatomical factors that may affect conception or be associated with recurrent miscarriages.
It is a minimally invasive, short-duration examination performed in the gynecological office and provides a clear view of the morphology of the uterine cavity.
What is hydrosonography?
Hydrosonography, also known as saline infusion sonography, is an examination in which a small amount of saline is infused into the uterus during a transvaginal ultrasound.
The saline gently distends the uterine cavity, allowing:
- better visualization of the inside of the uterus
- clearer detection of polyps or fibroids
- identification of adhesions
- assessment of congenital abnormalities
Unlike a standard transvaginal ultrasound, hydrosonography provides a more detailed image of the uterine cavity, particularly when pathology is suspected.
The examination lasts only a few minutes and usually causes only mild discomfort, similar to that of a gynecological check-up.
When is hydrosonography indicated in fertility investigation?
Hydrosonography is recommended when intrauterine pathology is suspected or when a more detailed assessment of the uterus is required as part of fertility investigation.
It is particularly indicated in cases of:
- difficulty conceiving without a clear cause
- recurrent miscarriages
- implantation failure in IVF cycles
- suspicious findings on a standard ultrasound
- abnormal bleeding
In infertility investigation, the correct morphology of the uterine cavity is of decisive importance. Even small anatomical changes, such as polyps or submucosal fibroids, may affect embryo implantation.
Hydrosonography often serves as an intermediate step before invasive methods, such as hysteroscopy, when confirmation or further investigation is required.
What does hydrosonography show?
Hydrosonography enables detailed imaging of the uterine cavity and detection of anatomical abnormalities that may affect fertility or the normal progression of a pregnancy.
With the help of saline infusion, the following can be identified more accurately:
Endometrial polyps
Small protrusions of the endometrium that may affect embryo implantation or be associated with abnormal bleeding.
Submucosal fibroids
Fibroids that protrude into the uterine cavity and may make conception more difficult or increase the risk of miscarriage.
Intrauterine adhesions
Adhesions (Asherman syndrome) that may create distortions of the cavity and affect implantation.
Congenital uterine abnormalities
Such as septa or other anatomical variations associated with recurrent miscarriages.
Accurate evaluation of the uterine cavity is particularly important before embryo transfer in IVF cycles, as it ensures that the implantation environment is anatomically suitable.
Hydrosonography and hysterosalpingography: What is the difference?
Hydrosonography and hysterosalpingography are examinations used in fertility investigation, but they evaluate different structures.
Hydrosonography is performed with transvaginal ultrasound and saline infusion, allowing detailed imaging of the uterine cavity. It is mainly used to detect polyps, fibroids, adhesions, or congenital uterine abnormalities and does not involve radiation.
Hysterosalpingography, on the other hand, is performed with contrast medium and radiological imaging and focuses mainly on tubal patency, meaning whether the fallopian tubes are open and allow natural conception.
The two examinations are often complementary and are selected according to the stage and needs of the investigation.
Frequently Asked Questions (FAQ)
Hydrosonography may cause mild discomfort or cramping similar to menstrual pain, especially during saline infusion. In most cases, the discomfort is temporary and well tolerated.
The examination is usually performed immediately after the end of menstruation and before ovulation. This timing allows better visualization of the uterine cavity and rules out possible pregnancy.
Usually, no special preparation is required. In some cases, preventive antibiotics may be administered, depending on the woman’s medical history.
Yes. In most cases, there is no restriction on trying to conceive in the same cycle, unless the doctor gives different instructions.
Hydrosonography is a safe examination with a low risk of complications when performed by a specialized physician. Mild bleeding or temporary pain may rarely occur.
Yes. Hydrosonography can reveal anatomical abnormalities of the uterine cavity, such as septa, polyps, or adhesions, which may affect implantation or the maintenance of a pregnancy.
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