If you're NOT getting pregnant, you may need to have your fallopian tubes checked!

With FemVue, Gynecologists can check your fallopian tubes in a simple office procedure!

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Sono HSG with FemVue

Sono HSG is a simple, well-tolerated ultrasound procedure used to evaluate the patency of the fallopian tubes, as well as detect abnormalities of the uterus. The procedure usually takes between 10 and 30 minutes to complete and the results are available immediately.

This ultrasound procedure requires the use of saline and air to see if the fallopian tubes are open because a fallopian tube cannot be seen with regular ultrasound and saline alone. The FemVue device is used to instill a consistent alternating pattern of saline and AIR in a continuous stream. This helps your doctor visualize your fallopian tubes and evaluate whether or not they are patent (open).

Sono HSG, which only uses saline, air and ultrasound is a safe and reliable alternative to the conventional hysterosalpingogram (HSG) which uses x-rays and x-ray contrast dye.

Procedure Details

Cost Effective

Office-based procedures like Sono HSG are cost-effective and benefit patients with or without fertility coverage when compared to an HSG performed in the hospital.


Tubal evaluations with FemVue are performed in the convenience of your doctor's office without the hassle of going to a radiology center or hospital for an HSG.

and It Works!

Many physicians have been offering FemVue for years and clinical studies have shown SonoHSG has comparable accuracy to an x-ray HSG.*

* Saunders RD, Shwayder JM, Nakajima ST. Current methods of tubal patency assessment. Fertil Sterili 2011;95:2171–79.

S. Maheux-Lacroix et al. Hysterosalpingosonography for diagnosing tubal occlusion in subfertile women: a systematic review with meta-analysis. Hum Reprod 2014;29(5):953-63.

Not Getting Pregnant?

If you have been unable to get pregnant after a year of trying or 6 months of trying if you're over 35, you may want to make an appointment with your doctor to have a fertility workup.

Common fertility evaluations

Evaluating the Ovaries:

Ovulatory dysfunction is a common cause of infertility and denotes a problem with the monthly release of an egg (ovulation). Testing for ovulatory issues is performed throughout the month and may include FSH Level, Progesterone Level, Ultrasound, and Endometrial Biopsy.

Evaluating the Fallopian Tubes:

Infertility is often caused by fallopian tube blockages. Either a hysterosalpingogram (HSG) involving x-rays and iodine-based dye or a Sono HSG using ultrasound and a saline and air contrast may be performed to see if the fallopian tubes are open.

Evaluating the Uterine Cavity:

Uterine abnormalities, fibroids, polyps and adhesions or scarring can prevent pregnancy. A saline sonogram, also known as a saline infusion sonogram (SIS), is an ultrasound test performed using saline instilled into the uterus to clearly outline many common abnormalities.

Evaluating the Cervix:

Vaginal and cervical viral and bacterial cultures are taken to detect any possible adverse infections that may be interfering with conception.

Male Factor Evaluation:

Various tests are performed to determine if the male is contributing to the infertility. A semen analysis can determine the volume of the ejaculate, the number of sperm (sperm count), their ability to move, the quality of the motility, and their shape (morphology).

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Should I Have My Tubes Evaluated?

Blocked fallopian tubes can greatly reduce your chances for pregnancy, as fallopian tube issues account for a significant percentage of infertility cases. Common problems can be related to tubal blockage or scarring from previous, sometimes undiagnosed, pelvic infection, abdominal infections like appendicitis, prior surgeries, prior ectopic pregnancy, or endometriosis.

According to the Practice Committee of the American Society for Reproductive Medicine, evaluation of the fallopian tubes is a key component of the diagnostic workup in infertile couples and identification of all relevant factors should be accomplished using the least invasive methods for detection.* Before taking fertility drugs (i.e. Clomid®, Serophene®, or Clomiphene Citrate), impediments to achieving pregnancy must be excluded or adequately treated before beginning therapy.**

*The Practice Committee of the American Society for Reproductive Medicine, Optimal evaluation of the infertile female, Fertility and Sterility. 2015;103:e44-50.
** CLOMID- clomiphene citrate tablet, Prescribing INDICATIONS AND USAGE, By sanofi-aventis U.S. LLC
Clomid is a registered trademark of Sanofi-Aventis, Inc.
Serophene is a registered trademark of Ares Trading SA.

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The Sono HSG Procedure

A Sono HSG begins like the first part of a pap smear, with a vaginal speculum gently inserted into the vagina to visualize the cervix. The cervix is then cleansed with antiseptic solution to decrease the risk of infection. A thin flexible balloon catheter is inserted through the opening of the cervix, so that the catheter lies within the uterine cavity. A balloon at the tip of the catheter is slowly inflated – this is necessary to stop fluid from leaking back out through the cervix during the test. The vaginal speculum is then removed, with the catheter remaining inside the uterus. A transvaginal ultrasound probe is inserted to conduct the internal scan through the vagina.

When the uterine cavity is being evaluated, sterile saline is introduced into the uterus through the catheter, distending the cavity and allowing the contour and shape to be assessed under ultrasound. The doctor will be looking for problems such as endometrial polyps, submucous fibroids and congenital uterine abnormalities (such as uterine septum).

When the fallopian tubes are being evaluated, the FemVue device is used to introduce a saline and air mixture through the catheter, allowing the tubes to be evaluated for patency (whether open). The transvaginal ultrasound probe and catheter are then removed at the end of the procedure.

Procedure video!

Read FemVue's Indications for Use

HSG vs. Sono HSG

A meta-analysis demonstrated that Sono HSG is an accurate test that performs similarly to an x-ray HSG. With comparable patient tolerability and the advantages of Sono-HSG over x-ray HSG, the analysis concluded Sono HSG should replace x-ray HSG in the initial workup of subfertile couples.1

  X-Ray HSG   Sono HSG
Procedure Location: Radiology center/Hospital   Your doctor's office
Performed by: Radiologist   Ob/Gyn or Fertility specialist
Imaging Method: Fluoroscopy   Ultrasound
Contrast:2 X-Ray dye   Saline and Air bubbles
Allergens: Iodine   None
Results: Follow-up call or
additional appointment
Referral Needed: Yes3   No

  1. S. Maheux-Lacroix et al. Hysterosalpingosonography for diagnosing tubal occlusion in subfertile women: a systematic review with meta-analysis. Hum Reprod 2014;29(5):953-63.
  2. A medical contrast medium (or contrast agent) is a substance used to enhance the contrast of structures or fluids within the body in medical imaging.
  3. The patient is responsible for verifying referral is accepted by their insurance company.

Frequently Asked Questions?

How important is it to check my fallopian tubes?

According to the American Society for Reproductive Medicine, "Evaluation of tubal patency is a key component of the diagnostic workup in infertile couples".

Should I have my fallopian tubes checked before using Clomid® or ovulation drugs?

Instructions for use for Clomid and other ovulation drugs indicate that all fertility factors should be evaluated prior to use, which includes making sure the fallopian tubes are open.

When can I get a Sono HSG?

Your procedure will be scheduled during the first half of your menstrual cycle, before you ovulate to reduce the chance of performing the procedure when you may be unknowingly pregnant.

Will I be given anything for possible discomfort?

Your doctor may advise you to take medications used for menstrual cramps to reduce possible mild cramping or discomfort.

What can I expect to know after the procedure?

Most women know during or right after the procedure whether their fallopian tubes are open or if there may be a blockage.

Is the procedure uncomfortable?

A Sono HSG may cause mild or moderate uterine cramping for about five to ten minutes.

What is the next step if my tubes are blocked?

Even if your tubes are blocked there are ways to overcome this problem and still get pregnant. Consult with your doctor for recommendations and possible next steps.