Saline Infusion Sonohysterogram (SIS) – Fertility Evaluation in Houston

Key Takeaways

• Saline sonogram or SIS is a safe, minimally invasive ultrasound procedure that uses sterile saline to uncover uterine cavity issues that can impact fertility, like polyps, fibroids, adhesions, and congenital shapes.
• The test is quick, usually under 30 minutes, performed transvaginally in clinic without anesthesia and may cause mild cramping or light spotting, with most patients resuming normal activities soon after.
• SIS gives high resolution evaluation of the endometrium and cavity and frequently delivers more precise diagnostic information than traditional pelvic ultrasound, directing the course of treatment for either surgery or fertility treatments.
• Schedule SIS after menstrual bleeding ends but before ovulation. Follow pre-procedure instructions like avoiding vaginal medications and emptying the bladder. Consider taking an over-the-counter pain reliever as recommended.
• Use SIS results together with hormone tests, semen analysis, and other evaluations to build a personalized treatment plan and discuss options such as monitoring, surgical correction, IUI, or IVF with your fertility team.
• Get ready for your follow-up. Review images and reports with your provider, keep a clear record of all test results, and make a checklist of questions to keep your care timely, coordinated, and on track.

A saline sonogram SIS Houston fertility care is a timed ultrasound procedure during which sterile saline is used to outline the uterine cavity. Clinics do it to detect fertility-impacting polyps, fibroids, or scarring.

The test, which is low risk, lasts about 10 to 20 minutes with live ultrasound pictures. The results help doctors to plan treatments like hysteroscopy or assisted reproduction.

They do a great job explaining preparation, process, and interpretation in the following sections.

Understanding SIS

A Saline Infusion Sonohysterogram (SIS) is a focused ultrasound exam that introduces sterile saline into the uterine cavity through a small catheter to evaluate the inside of the uterus. The saline stretches the uterine lining, creating a clearer contrast on transvaginal ultrasound so clinicians can see shape, lining defects, and small lesions that a standard ultrasound might miss.

The test is widely used in reproductive medicine to help explain abnormal bleeding, recurrent miscarriage, or unexplained infertility.

1. The Procedure

The process begins with the patient on an exam table while a speculum is placed to access the cervix. A thin catheter is passed through the cervix and gently secured. Sterile saline is injected slowly while a transvaginal ultrasound probe images the uterus in real time.

Skilled clinicians or fertility specialists perform the test in a clinic. It is an outpatient procedure and typically takes between 10 and 30 minutes. No general anesthesia is required, though local measures or a pain reliever beforehand may be suggested.

2. The Sensation

Most women experience some cramping or pelvic pressure as the saline fills the cavity. These sensations are similar to a heavy menstrual cramp for a brief period. Discomfort tends to be short-lived and mild.

The majority return to normal activities the same day. Light spotting or watery discharge is normal for a day or several days following the test and generally aren’t a cause for concern. For a short period, follow your doctor’s advice to use a pad and avoid tampons or intercourse to minimize the risk of infection.

3. The Findings

SIS provides detailed images of the uterine lining and cavity, assisting in the detection of polyps, fibroids impinging on the cavity, intrauterine adhesions, uterine septa, and abnormal shapes.

These results can account for reasons of unusual bleeding, recurrent miscarriage, or failed IVF implantation. The findings direct what to do next—medical management, hysteroscopic surgery, or targeted fertility planning.

The sonohysterogram does not treat fertility. In certain instances, the exam has been associated with increased pregnancy rates in the time period following the test, although processes are uncertain.

4. The Timing

Try to schedule your SIS once the menstrual bleeding has stopped and before ovulation, which usually means in the week after your period. This improves visualization and ensures you don’t disrupt an early pregnancy.

For patients on hormonal contraception or other treatments, timing might be modified by the clinic. Monitoring the cycle assists you in selecting the optimal day and minimizes your potential for infection.

5. The Preparation

Follow clinic instructions: avoid intercourse and vaginal medications before the test, empty the bladder for clearer imaging, and tell the clinician about allergies, recent infections, or current medications.

Taking ibuprofen about an hour before can help reduce cramping. Sonohysterography has limits in some clinical situations and carries a small infection risk of roughly 0.95%.

Diagnostic Clarity

A saline infusion sonohysterogram (SHG), commonly referred to as a saline sonogram or SIS, is a specialized imaging procedure that provides a detailed view of the uterine cavity and endometrium. It provides ancillary detail beyond a typical pelvic ultrasound and is appropriately timed and utilized to minimize infection risk and prevent iatrogenic miscarriage of an early pregnancy.

Diagnostic clarity from SIS gives both clinicians and patients a better understanding of the causes of infertility, helps guide treatment decisions, and alleviates the ambiguity that can come with the fertility workup.

Uterine Shape

SIS maps the internal contours of the uterus and displays abnormal shapes, such as bicornuate, septate, lupus, or unicornuate, that can disrupt embryo implantation. Such accurate mapping helps determine if corrective surgery, like a hysteroscopic septum resection, is necessary before trying to conceive or undergo IVF.

Diagnosing a septate uterus can account for recurrent miscarriage or repeated IVF failure and can alter treatment.

• Common uterine shape anomalies detectable by SIS:
  • Septate uterus
  • Bicornuate uterus
  • Unicornuate uterus
  • Didelphys uterus
  • Arcuate uterus

Cavity Health

SIS of the endometrium and cavity surface can demonstrate adhesions (Asherman’s), scar tissue, and retained products from procedures or pregnancies. It can identify thin, thick, or irregular lining — information that impacts implantation potential.

Findings guide fertility decisions: adhesions may need hysteroscopic lysis, persistent thickened areas may require biopsy or medical therapy, and retained tissue may prompt surgical removal. Timing is important — when SIS is done within roughly 10 days of the start of the period, it is both clearer and less likely to cause infection.

A few patients do complain of cramping for a few hours post-procedure. Therefore, pain control and follow-up is important because pain can prohibit you from completing your imaging and therefore compromise your diagnostic clarity.

Tissue Growth

SIS is sensitive for small intrauterine lesions and can differentiate polyps, submucosal fibroids, and other focal growths from normal lining. Most of them induce irregular bleeding, pelvic pain, or infertility and require surgical excision to return to normal.

SIS aids in distinguishing lesions that are likely benign from those requiring further evaluation with hysteroscopy or directed biopsy.

Examples of tissue growths commonly visualized by SIS:

• Endometrial polyps
• Submucosal fibroids
• Endometrial hyperplasia nodules
• Retained products of conception

Sophisticated imaging such as SIS enhances diagnostic clarity relative to standard ultrasound. Pairing SIS with hysteroscopy or sonographic follow-up may provide a more comprehensive view. Infection or other complications can confound clarity, so careful patient selection and monitoring are key.

Comparative View

Saline infusion sonohysterography (SIS) is a targeted ultrasound technique that expands the uterine cavity with saline to expose intrauterine lesions and contour irregularities. Here’s a direct comparison with other standard diagnostics in fertility workups, the practical compromises, and where SIS generally slots into clinical algorithms.

Versus HSG

SIS uses sterile saline and transvaginal ultrasound to image the uterine cavity and endometrium. Hysterosalpingography (HSG) uses iodinated contrast and X-ray to outline the cavity and, importantly, the fallopian tubes. HSG exposes the patient to ionizing radiation and a contrast medium. SIS avoids both, making it preferable when limiting radiation is a priority.

SIS gives superior soft-tissue detail of the endometrium and submucosal lesions. Multiple studies report higher sensitivity and specificity for SIS versus plain transvaginal ultrasound in detecting polyps, fibroids, and adhesions. Patients generally tolerate sonographic contrast methods well. HyCoSy and HyFoSy studies report better comfort than X-ray HSG in many outpatient settings.

HSG still has a role for testing tubal patency and imaging proximal and distal tubal blocks. Laparoscopy with dye remains the gold standard for tubal evaluation, but contemporary ultrasound-based foam or contrast sonography (HyFoSy, HyCoSy) has emerged as accurate and widely used alternatives.

The table below emphasizes key distinctions.

Versus Hysteroscopy

Hysteroscopy permits direct visualization with a camera and instant operative intervention, like polyp removal, lysis of adhesions, or directed biopsy. SIS is a minimally invasive, outpatient screening tool that requires no general anesthesia in the majority of cases and confers lower procedural risk.

SIS can’t treat lesions it detects. When SIS raises the possibility of a focal lesion, hysteroscopy is warranted for verification and potential treatment. Studies suggest hysteroscopy may be marginally better for certain intrauterine pathology.

Sonohysterography often has similar diagnostic accuracy and is better tolerated. Use SIS when preliminary, low-risk evaluation is desired. Use hysteroscopy when intervention or conclusive diagnosis is required, or when SIS results are ambiguous.

The Houston Approach

The Houston approach, known as Saline Infusion Sonohysterogram (SIS), is a minimally invasive imaging procedure used to evaluate the inside of the uterus. Clinics in Houston use SIS as part of a broader fertility workup to detect uterine problems that may affect conception and pregnancy.

The test is brief, typically less than 10 minutes, and is done with a baseline transvaginal ultrasound first, then with gentle infusion of saline to outline the uterine cavity. Timing is important; most centers schedule SIS just after a period and within 10 days of the first day of bleeding to lower infection risk and avoid disrupting a very early pregnancy.

Local Expertise

Houston fertility Center, stress hands-on skill. Our expert clinicians, including Dr. Sonja Kristiansen and Dr. Puthoff, are nationally recognized in the area for SIS expertise and handling complex infertility cases.

Most clinics have specialized ultrasound suites for detailed pelvic scanning and saline sonography, with staff trained in difficult anatomy or prior uterine surgery. Skilled ultrasonographers and fertility endocrinologists collaborate to read SIS pictures, differentiating polyps, submucosal fibroids, congenital shapes, adhesions, or suspicious masses.

Top Houston centers that frequently offer SIS include Conceptions Fertility Center and Aspire Houston Infertility Institute, among other practices that combine imaging with reproductive medicine.

Integrated Care

SIS in Houston is rarely a stand-alone test. It fits into an integrated diagnostic plan. Results are compared with ovarian reserve testing, semen analysis, and baseline hormone panels so teams see the full picture.

Radiologists, gynecologists, and embryologists coordinate findings to shape treatment paths, whether surgical correction, intrauterine insemination, or in vitro fertilization. SIS findings often guide decisions on endometrial biopsy or genetic screening by showing cavity irregularities that warrant further sampling.

This coordinated approach improves diagnostic accuracy and helps tailor interventions to the patient’s goals, which can raise the chance of successful pregnancy.

Patient Experience

Houston clinics want to make SIS simple and as comfortable as they can. Patients are given explicit directions in advance, know what to anticipate during the short procedure, and receive post-procedure advice about spotting or cramping.

Cramping from saline infusion is common but generally brief. Some women spot for a couple of days. Most return to normal activity the same day. Centers stress safety. Infection is rare, at about 0.95%, and staff take precautions to reduce that risk.

Patient reviews are typically replete with praise for their professional teams, on-time scheduling, and quick turnaround reporting of results, further instilling confidence in the care pathway.

Beyond The Images

A saline sonogram, or sonohysterography (SIS), offers more than images. It produces tangible results that can transform how both patients and clinicians think about fertility. The test detects abnormal uterine shape, scar tissue, polyps, fibroids, endometrial adhesions, cancerous lesions, and congenital abnormalities.

Timing matters: SIS is usually done in the first half of the menstrual cycle, after bleeding stops, to lower infection risk and avoid disrupting an early pregnancy. Others cramp for hours and spot for days after. Complications are uncommon but may include vasovagal response, pelvic pain, nausea, fever, or rarely, infection (0.95%). Women who are or might be pregnant, or who have a current pelvic infection or PID, should not have the test.

Emotional Insight

SIS can provide emotional respite when it sheds light on an underlying cause behind unexplained bleeding, miscarriage, or failed fertility treatments. Definitive outcomes can lighten the deep burden of worry that many bear, while inconclusive or abnormal results may ignite fresh concerns that require time and nurturance to digest.

Patients should be encouraged to express concerns and request reassurance from their care team pre, during, and post procedure. Casual conversation can reduce stress and assist in planning realistic forward moves.

When SIS pinpoints a particular problem, it can substitute months of uncertainty with a clear course of action. That shift can reduce persistent stress and allow couples or individuals to concentrate on next steps instead of what-if scenarios.

• What did you view in the pictures and what is their significance?
• How likely is this finding to affect my fertility?
• Which treatments would you recommend next and why?
• What are the risks and benefits of those treatments?
• How soon can we act on these results?
• What symptoms should prompt urgent contact?
• Can I get copies of the images and report?

A Pivotal Step

SIS is an important landmark in a fertility workup. These findings can steer whether to attempt IUI, proceed to IVF or refer for surgery to remove polyps, fibroids, or adhesions. Correct detection spares needless procedures and stalling.

If uterine shape or adhesions are the issue, correcting them can significantly increase the likelihood of pregnancy. Well-timed SIS frequently accelerates the route to conception by targeting therapy on the actual impediment instead of treating by trial.

Gaining Control

Knowing your SIS outcomes enables patients to be proactive. Request to see both the images and the report with the specialist to understand the clinical context. Document menstrual patterns, symptoms, and past tests. That context hones clinical decisions and follow-up.

Checklist to prepare a summary of tests:

1. Test Result: January 15, 2023 Highlight: Achieved a 95% accuracy rate. Commentary: This result indicates a strong performance in the evaluation process.
3. Test Result: February 20, 2023 Highlight: Identified key areas for improvement. Commentary: Recognizing these areas is crucial for future enhancements.
5. Test Result: March 10, 2023 Highlight: Increased user engagement by 30%. Commentary: This increase suggests that recent changes have positively impacted user interaction.
7. Test Result: April 5, 2023 Highlight: Reduced error rate to 2%. Commentary: A lower error rate reflects improved accuracy and reliability in the results.
9. Test Result: May 22, 2023 Highlight: Expanded the dataset by 50%. Commentary: A larger dataset allows for more comprehensive analysis and insights.

1. Upcoming tests and their purpose, plus scheduled dates.
2. Current medications, allergies, and prior surgeries with dates.
3. Symptom log for a minimum of three cycles, including bleeding, cramps, and any abnormal discharge.
4. Ultrasound pictures copies, SIS report, pathology if applicable.

Your Next Steps

A quick overview of what happens after an SIS helps manage expectations and guarantees results transition into care decisions. The steps below cover how to read results with your provider, how findings inform a tailored fertility plan, when to schedule follow-ups, and how to keep clear records of all diagnostics.

Interpreting Results

Go over the SIS pictures and report with your fertility specialist or OB-GYN. Request to view the still images and clips of the uterine cavity after saline infusion. Search for regions marked as potential polyps, fibroids, or adhesions and ask for lay notes on any terminology you’re unfamiliar with.

Each of the findings ties to fertility in a different way. Polyps can disrupt embryo implantation and are typically small and easily removed. Submucosal fibroids may cause distortion of the cavity and decrease success of IUI and IVF. Adhesions can obstruct implantation or lead to recurrent pregnancy loss. Know which of these your result falls into and inquire about the average results post treatment for that lesion.

Make a checklist of questions before the consultation: What exactly was seen? How confident is the diagnosis? Are additional tests needed? What risks or benefits attach to treating it now versus monitoring? Keep the SIS report, ultrasound images, and other test results together in one folder or digital file for quick reference during visits.

Treatment Planning

Collaborate with your fertility team to transform SIS results into a transparent, stepwise plan. If a polyp or submucosal fibroid is detected, you may be recommended surgery, such as a hysteroscopic removal, prior to trying IUI or IVF. If the cavity appears normal but other elements are present, treatment could involve medication or proceeding directly to assisted reproductive technologies.

Potential next steps include watchful waiting with repeat imaging, medication for inflammation or hormonal issues, hysteroscopic surgery, IUI, or IVF. Discuss pros and cons. Surgery may improve implantation but carries procedure risks. IVF may bypass some uterine issues but is more costly and invasive.

Add any pre-op visits, medication start dates, planned procedures, and so on to your treatment calendar right after your visit. Practical points about the SIS itself matter. Ideally, the test is done within ten days after the first day of your period to lower infection risk and avoid disrupting a very early pregnancy.

Expect light vaginal spotting for a few days afterward, and that saline will drain over hours—wear an absorbent pad. You can eat normally that day, but report severe pain or fever right away. Infection is rare, at about 0.95 percent. Clear documentation of every step helps future decisions.

Conclusion

A saline sonogram (SIS) provides focused, vivid images of the uterus. It detects polyps, fibroids, and scar tissue quickly. In Houston, SIS works hand in hand with history and basic testing at clinics to direct care for fertility. The test is significantly less expensive than many scans and only takes 10 to 20 minutes. A woman may experience slight cramp or pressure and then carry on with her day.

For couples, SIS narrows down causes and points to focused steps: minor procedures, timed cycles, or referral to a fertility specialist. For clinicians, SIS provides specific, actionable detail.

If you’re looking for a targeted, low-risk screen for uterine problems, book a clinic that does SIS and has a straightforward care pathway.

Frequently Asked Questions

What is a saline sonogram (SIS) and why is it done?

SIS stands for saline infusion sonogram, an ultrasound that uses sterile saline to outline the uterine cavity. It looks for polyps, fibroids, scar tissue or congenital problems that can impact fertility and inform treatment.

Is SIS safe and painful?

SIS is low-risk. Most patients experience mild cramping that feels like a menstrual cramp. Serious complications are infrequent. Your clinician will use sterile technique and can provide pain control if required.

How long does the SIS procedure take and when is it scheduled?

The procedure lasts approximately 10 to 20 minutes. It’s typically performed during the early follicular phase (days 6 to 10) of a normal cycle to obtain clear images and avoid interfering with a potential early pregnancy.

How accurate is SIS compared with other tests?

SIS is highly sensitive for detecting intrauterine abnormalities and it’s less invasive and less expensive than hysteroscopy. It supplements and occasionally supplants diagnostic hysteroscopy or MRI for a number of uterine problems.

Will an SIS affect my fertility treatment plan in Houston fertility clinics?

Yes. SIS findings assist specialists in customizing fertility treatments by uncovering treatable uterine abnormalities. Results frequently alter the course of treatment for IUI, IVF, or even surgical repair to optimize success.

Do I need special preparation before an SIS?

They might instruct you to abstain from intercourse and take a mild pain reliever prior to the test. Be sure to tell your provider if you have any allergies, pelvic infections or if you’re pregnant. Adhere to any clinic-specific directions.

How soon will I get results and what comes next?

Your provider generally reviews all images right away and walks you through findings that day. Next steps might include conservative treatment, surgical correction, or referral to a fertility specialist for individualized care.