Published 28 Nov, 2025
2 min. read

The Three H’s: Hysteroscopy, Hysterosonography, Hysterosalpingography

Learn what hysteroscopy, hysterosonography, and hysterosalpingography are and how they help diagnose infertility and uterine conditions.

The Three H’s: Hysteroscopy, Hysterosonography, Hysterosalpingography

Many women undergoing infertility evaluation receive recommendations for one or more of these three imaging investigations, as they are essential in determining why conception does not occur and in diagnosing multiple gynecological conditions.

All three procedures allow detailed evaluation of the uterus and fallopian tubes — structures frequently involved in female infertility. Tubal patency, uterine architecture, and endometrial abnormalities can be assessed with precision using these methods.

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Hysteroscopy

Hysteroscopy is minimally invasive and allows both diagnosis and treatment. The hysteroscope, a thin optical instrument, is inserted into the uterus, and saline or air is used to open the cavity for visualization. It may be performed with local or general anesthesia and lasts up to 40 minutes.

Hysterosonography

This procedure involves injecting saline into the uterus via a thin catheter, under ultrasound guidance. It helps diagnose polyps, fibroids, adhesions, congenital uterine anomalies, and assess tubal patency. It is performed between days 5 and 10 of the cycle.

Hysterosalpingography (HSG)

HSG uses contrast dye and X-ray imaging to evaluate the uterine cavity and fallopian tube patency. It is recommended for women with infertility, recurrent miscarriage, severe menstrual pain, or abnormal bleeding. The test lasts 15–30 minutes and is ideally performed in the first two weeks after menstruation.

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Hysteroscopy, Hysterosonography, and Hysterosalpingography

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