Sonohysteragram, HyCoSy Tubal Patency Assessment


This scan is an ultrasound to look at the uterus and ovaries. It is usually done to investigate the cause of pain or abnormal bleeding. It may also be requested to follow-up a previously diagnosed ovarian cyst, uterine fibroids or to locate an IUCD.

Although we may start with some images taken through your stomach, in a sexually active woman we prefer to also do the a transvaginal scan after you have emptied your bladder because the quality of the imaging is generally much better.

The vaginal scan involves placing a finger like transducer (the ultrasound probe) inside the vagina. The probe is sterilized and covered with a disposable sheath to protect you and others from the risk of infection. The scan is then done by gently angling the probe towards the womb and ovaries on both sides. Most women find the scan process mildly uncomfortable rather than painful.

In a scan done to investigate abnormal bleeding the main focus is to look at the lining of the womb that gives rise to periods. This is easiest to do in the first 5 days after finishing a period.

If we cannot see the lining well with the transvaginal scan we may suggest proceeding with a saline sonogram. This involves a procedure similar to a pap smear. The doctor will pass a very fine plastic tube and 20mls of a warm saline solution into the cervix. This separates the internal wall of the womb slightly so that small abnormalities such as polyps (similar to small skin tags) and fibroids (non cancerous growths of the womb) can be better seen. If we feel you require the saline sonogram at the time of your visit this will be discussed with you first.

Important points:
Try to book this scan in the first half of your cycle
Come with a moderately full bladder (2 glasses of water 1 hour before the scan)
Part of the examination is a transvaginal scan unless you are not sexually active or your doctor has specifically requested us not to do so
Some of our sonographers are male – if you do not want a male sonographer please discuss this at the time of booking and we will book you with a female.


This scan is done to look for blockages in the fallopian tubes when a woman is having trouble falling pregnant. It compliments other investigations such as ovulation test and sperm analysis. It may also be done as preliminary test before IVF.

It involves a procedure similar to a pap smear in which a very fine plastic tube is passed through the cervix. You are then scanned with a small probe in the vagina (read gynecological scan description above). A fluid solution is slowly injected through the plastic tube and into the womb. We watch for the movement of the fluid into the fallopian tubes on the ultrasound over the next 5-10 minutes. We will let you know what we are seeing. If no flow is seen on either side then there is a 90% chance that your tubes are blocked or scarred and IVF may be necessary. A single blocked tube is not a significant problem.

Because the procedure can cause period like pains we recommend you to take 2 naprogesic or ponstan* tablets 1 hour before the test. It is preferable to book the test within 12 days of starting a period. We will do a urinary pregnancy test prior to the scan


Woman over 50 and those with a strong family history of breast and ovarian cancer may benefit from ultrasound examination to check for suspicious ovarian cysts.
Though not an established screening test like mammography or Pap smears, transvaginal ultrasound in conjunction with your doctor’s clinical assessment and blood tests, have been used to track ovaries in woman at risk of ovarian cancer.

If an ovarian cyst is identified the ultrasound characteristics are used to distinguish the cyst with a low chance of being a cancer from that with a moderate -high risk. Low risk cysts can usually be observed but any suspicious lesion is referred to a gynaecological surgeon.

Because the correct interval for effective testing is not known we generally recommend annual check for high risk women.