Evaluation of fallopian tubes forms an essential part of evaluation
Tubal pathology is a cause of infertility in 30- 35% of infertile patients
Tubal Assessment
Fallopian tubes can be assessed by:
Hysterosalpingography
Hysterosalpingo-contrast-sonography (HycoSy)
Sonosalpingography
Laparoscopy & CHROMOTUBATION
4. SONO-HYSTERO
SALPINGO-GRAPHY
• It is a procedure for testing tubal
patency similar to HSG HyCoSy
done under transvaginal ultrasound
guidance using sterile saline.
It can also be used to investigate
endometrial and the endometrial
cavity.
5. Indications
• Infertility
• Prior to assisted conception
• Abnormal uterine bleeding.
• Recurrent pregnancy loss to assess the
cavity.
• Amenorrhea or oligomenorrhoea
7. The normal and healthy fallopianThe normal and healthy fallopian
tubes are usually not seen bytubes are usually not seen by
transvaginal sonography unlesstransvaginal sonography unless
they contain fluid within theirthey contain fluid within their
lumen or are surrounded by fluid.lumen or are surrounded by fluid.
Tubes not visualized because :Tubes not visualized because :
1.Small diameter < 4 mm
2.Serpinginous course
8. SONOSALPINGOGRAPHY
(SION TEST)
Sonosalpingography (SSG) uses
transvaginal sonography to confirm tubal
patency by visualizing turbulence near
the fimbrial end when a mixture of air and
saline is injected through a Foley’s catheter
placed within the uterus.
11. ‘Sion test’
using sterile saline solution as a
negative contrast medium alongwith
with transvaginal ultrasound one canone can
evaluate the tubal patency, image theevaluate the tubal patency, image the
uterine cavity and assess the pelvisuterine cavity and assess the pelvis
18. broad-based, hypoechoic,
With myomas the endometrial-
myometrial interface is distorted
The Thickened endometrium
may be a Submucosal leiomyomas
19. BenefitsBenefits
Office procedure
Low technology / Low cost
Better resolution
Better tolerability
No radiation exposure
Each tube can be assessed separately
Provides an accurate and more complete
assessment of uterine anatomy
20. LimitationsLimitations
Site of the tubal block not identified
Intra tubal mucosal pathology not
identified
Mobility of tube not assessed
There is risk of infection and pain.
23. HSGHSG SSGSSG
Sensitivity Specificity Sensitivity Specificity
Randolf et al
(1986) 97 93 99 95
Sharma R.P.
(1989) ------------------- 98 96
Tufekci et al
(1992) ------------------- 90 96
Allahabadia et al
(1992) 88 80 98 91
24. USP
of SonosalpingographySonosalpingography
• The accuracy of saline SSG is comparable to
office hysteroscopy in detecting polyps,
fibroids and focal endometrial thickening. It is
better than HCG and transvaginal sonography
in detecting abnormalities of uterine cavity
and cause less pain than hysteroscopy and
concurrent assessment of uterine cavity and
tubal patency is possible a now it is to foured
in all infertility guidelines.
26. CONCLUSION
Sonosalpingography (Sion test) is
an inexpensive , noninvasive ,
simple screening test that can be
done in the gynecologist's office at
the same time with endometrial
sampling in infertility evaluation.
Our experience of 5000 plus cases
speaks volume about it.
27. Sonohysterosalpingography
• It is a procedure for testing tubal
patency similar to HSG HyCoSy
done under transvaginal ultrasound
guidance using sterile saline.
It can also be used to investigate
endometrial and the endometrial
cavity.
28. ISO 14001:2004 (EMS)
…..Caring hearts, healing
hands
ISO 9001:2008
HELPLINE-9650588339/22414049
HELPLINE-9599044257
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HELPLINE
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