Revised 2021
What is saline infusion sonohysterogram (SHG)?
Saline infusion sonohysterography (SIS or SHG) is a well-tolerated procedure to evaluate the uterus, especially the shape of the cavity. SHG uses ultrasound and sterile fluid to show the uterus, endometrial (uterine lining) cavity, and ovaries. The purpose of this procedure is to detect any abnormalities such as fibroids in the cavity, a uterine septum, or adhesions.
Why is SHG performed?
SHG can be done to investigate a variety of conditions such as abnormal uterine bleeding, infertility, and recurrent miscarriages. SHG can also be performed to see the structure of the uterus. This may be done in women with congenital abnormalities (birth defects) of the uterus, before and after surgery on the uterus, or to detect problems that appear later in life such as polyps or suspected scar tissue inside the uterus. SHG may also help check uterine abnormalities found during a routine ultrasound. SHG may also cause mild cramping, spotting, and vaginal discharge. Some women have cramping for several hours after the procedure. It is often recommended to take a medication such as ibuprofen before this test. Some doctors may also prescribe stronger pain medication and/or antibiotics before the procedure. You should call your doctor if you experience pain or fever in the 1–2 days after the SHG.SHG should not be performed in women who are pregnant or who are suspected to be pregnant. SHG should also not be performed in women with an active pelvic infection.
What are the risk and complications?
SHG is a very safe procedure and usually is performed without incident. Serious complications are rare. The most common serious complication with SHG is pelvic infection. However, this occurs less than 1% of the time and usually occurs when a woman also has a block or infection of the fallopian tubes.
Fact Sheets/Booklets
View more fact sheets and booklets written by the ASRM Patient Education Committee.
Menopausal Transition (Perimenopause): What Is It?
The menopausal transition (perimenopause) is the period that links a woman’s reproductive (childbearing) years and menopause.
Osteoporosis
Osteoporosis and osteopenia are conditions of having low bone mass (density).
Hyperprolactinemia (High Prolactin Levels)
Prolactin is a hormone produced by your pituitary gland which sits at the bottom of the brain.Resources For You
The American Society for Reproductive Medicine (ASRM) is committed to providing patients with the highest quality information about reproductive care.
Infertility
SART Fertility Experts - Military Families and Fertility
Active-duty individuals in the military sometimes face unique circumstances when seeking fertility care. Learn more with a former military fertility physician. Listen to the Episode
SART Fertility Experts - Q&A on Infertility
Infertility can create many questions for a patient. Listen to common questions and answers about infertility, egg freezing, and genetic testing. Listen to the Episode
Fertility Care Gets Important Win in California
ASRM celebrates California's SB 729, expanding IVF coverage for same-sex couples and singles, advancing equitable fertility care access.
View the Press Release
National Infertility Awareness Week
April 20-26, 2025, is National Infertility Awareness Week (NIAW)!
View the NIAW Toolkit
ASRM announces support for HOPE with Fertility Services Act
The American Society for Reproductive Medicine is proud to endorse the HOPE with Fertility Services Act (HR 8821).
View the Press Release
SART Fertility Experts - Environmental Impacts on Fertility
In this episode, the fertility experts discuss the impact of the environment, including air, climate, and chemical exposures on infertility. Listen to the Episode
Survey shows strong support for increased access to fertility treatments
A new public opinion poll reveals strong support for improved access to In Vitro Fertilization (IVF).
View the Press Release
Leave Your Mark! NIAW April 21-27
National Infertility Awareness Week Action Round-Up Click here to leave your mark during NIAW2024
National Infertility Awareness Week 2024: Leave Your Mark
Next week is National Infertility Awareness Week, a federally recognized health observance founded to increase awareness of infertility.
View the Press Release
SART Fertility Experts - Recurrent Pregnancy Loss and Implantation Failure
"I can get pregnant, but I can't stay pregnant," is echoed by patients with recurrent pregnancy loss. Listen to the Episode
SART Fertility Experts - Wellness and Fertility: Diet, Sleep and Exercise
Drs. Timothy Hickman and Rashmi Kudesia discuss the links between lifestyle and fertility. Listen to the Episode
SART Fertility Experts - Navigating IVF as a Couple
Mary Casey Jacob, PhD is interviewed by Dr. Daniel Grow, and together they explore the emotional and practical support that couples need. Listen to the Episode
Male Fertility Journey
About 20% of infertility cases are due to a male factor alone. Another 30% involves both male and female factors.
View the Patient Journey
Female Fertility Journey
If you've been trying to get pregnant for more than a year, you may have infertility. Infertility is a disease of the reproductive system that impairs one of the body's most basic functions: the conception of children.
View the Patient Journey
Stress and infertility
It is not clear how exactly stress impacts fertility. Read the Fact Sheet
Hyperprolactinemia (High Prolactin Levels)
Prolactin is a hormone produced by your pituitary gland which sits at the bottom of the brain. Read the fact sheet
Optimizing Natural Fertility
Before attempting pregnancy, a woman should make sure she is healthy enough for pregnancy by adopting a healthier lifestyle and taking prenatal vitamins. If she has a medical or genetic condition or risk of one, she should seek advice from a medical professional before conceiving (becoming pregnant) View the fact sheet
Optimizing Male Fertility
About 20% of infertility cases are due to a male factor alone. Another 30% involves both male and female factors. View the fact sheet
Defining Infertility
Infertility is “the inability to conceive after 12 months of unprotected intercourse.” View the Fact Sheet
Fertility Rights and Responsibilities
Can a fertility program or clinic deny treatment to patient(s) if there is concern about the ability to care for the child(ren)? Yes. Fertility programs can withhold services if there are signs that patients will not be able to care for child(ren). View this Fact Sheet
Male Fertility Evaluation: What do I need to know?
Infertility is the inability to achieve pregnancy after one year of unprotected sex. View the fact sheet
Smoking and infertility
Most people understand that smoking increases the risk for heart, vascular, and lung disease. View the fact sheet
What are fibroids?
Uterine fibroids (also called myomas or leiomyomas) are benign (noncancerous) tumors of muscle tissue found in the uterus. View the fact sheet
Infertility Counseling and Support: When and Where to Find It
Infertility is a medical condition that touches all aspects of your life. View the fact sheet
What is In Vitro Maturation (IVM)?
In vitro maturation (IVM) is when a woman’s eggs are collected and matured outside the body. This is done as part of an in vitro fertilization (IVF) procedure. View the fact sheet
SART Fertility Experts - Endometriosis
Endometriosis is a condition that can affect many facets of a person’s life, from pelvic pain to struggles with infertility. Listen to the Episode
SART Fertility Experts - Recurrent Pregnancy Loss
Candace discusses her experience with infertility, IVF, multiple pregnancy losses and ultimately a successful delivery with Dr. Julia Woodward.Listen to the Episode
SART Fertility Experts - Financial Aspects of Infertility Treatment
“I know what treatment I want and need to do, but how can I afford it?” This is a common question infertility patients often ask themselves. Listen to the Episode
SART Fertility Experts - Infertility Advocacy and Government Affairs
In today's episode, Dr. Mark Trolice interviews Sean Tipton about the fact that many infertility patients do not have insurance coverage for treatment. Listen to the Episode
SART Fertility Experts - Your Infertility Nurse: Partner in Your Care
Infertility nurse practitioner and health coach Monica Moore explains the essential role of the infertility nurse in the IVF process. Listen to the Episode
Intracytoplasmic sperm injection (ICSI)
A procedure called intracytoplasmic sperm injection (ICSI) can be done along with in vitro fertilization (IVF) if a sperm cannot penetrate the outer layer of an egg. Read the Fact Sheet
SART Fertility Experts - IVF: Cycles of Hope and Heartbreak
Does stress cause infertility or is it the other way round? Listen to the Episode
SART Fertility Experts - RESOLVE and Infertility
Due to the unique stress of infertility, patients often look for resources and support in addition to those provided by their medical provider. Listen to the Episode
What is Recurrent Pregnancy Loss (RPL)?
This is a condition when a woman has 2 or more clinical pregnancy losses (miscarriages) before the pregnancies reach 20 weeks. View the fact sheet
What is Premature Ovarian Insufficiency (Previously Called Premature Ovarian Failure)?
When a woman’s ovaries stop working before age 40, she is said to have premature ovarian insufficiency (POI). View the fact sheet
Testosterone use and male infertility
Testosterone (also referred to as “T”) is a hormone produced in men by the testes (testicles). View the fact sheet
SART Fertility Experts - Safe Surfing: The Pros and Perils of Social Media
Dr. Kenan Omurtag, MD joins host Dr. Mark Trolice to discuss the use of social media in the field of infertility. Listen to the Episode
SART Fertility Experts - What is an REI?
These experts in infertility lead IVF programs, perform reproductive surgery, and perform research to enhance the field of reproductive medicine. Listen to the Episode
Stress and Infertility
Medical procedures, cost, outcome uncertainty, and unwanted or unhelpful advice from friends and family are stressors associated with infertility treatment. Watch Video
Infertility: an Overview (booklet)
Infertility is typically defined as the inability to achieve pregnancy after one year of unprotected intercourse. View the booklet
Male Fertility and Infertility - a patient education video
Male Factor Infertility is responsible for about 30% of infertility cases and can contribute infertility to an additional 20% of cases. Watch Video
Infertility
Infertility is the result of a disease (an interruption, cessation, or disorder of body functions, systems, or organs) of the male or female reproductive tract which prevents the conception of a child or the ability to carry a pregnancy to delivery. Watch Video
Basic Infertility Evaluation
Dr. Roger Lobo of the American Society for Reproductive Medicine discusses the various methods to evaluate infertility. Watch Video
Fibroid Tumors
An educational video that answers patient questions about the causes, symptoms, diagnosis and management of uterine fibroids. Watch Video
Infertility Treatments
Dr. Roger Lobo of the American Society for Reproductive Medicine discusses the various treatments for infertility. Watch Video
Understanding Fertility
In this video series, Dr. Roger Lobo explains the basics of infertility, including causes, treatments and coping methods. Watch Video
Surviving the Roller Coaster Emotions of Infertility Treatment
The experience of infertility is a rollercoaster of hope and disappointment. Treatment presents an opportunity for hope as well as a new set of challenges. Watch Video
Acupuncture and Infertility Treatment
Acupuncture is an alternative medical treatment that involves placing very thin needles at different points on the body. View the Fact Sheet
Sexual dysfunction and infertility
Sexual dysfunction is a problem in a person’s sexual desire, arousal, or orgasm. View the fact sheet
Coping With Infertility
Dr. Roger Lobo of the American Society for Reproductive Medicine discusses various methods of coping with infertility. Watch Video
Endometriosis
Endometriosis is a condition in which endometrial tissue, which normally lines the uterus, develops outside of the uterine cavity in abnormal locations. Watch Video
Causes of Female Infertility
Dr. Roger Lobo, of the American Society for Reproductive Medicine explains the causes of female infertility. Watch Video
Age and Fertility (booklet)
Generally, reproductive potential decreases as women get older, and fertility can be expected to end 5 to 10 years before menopause. View the Booklet
Causes of Male Infertility
Dr. Roger Lobo, of the American Society for Reproductive Medicine explains the causes of male infertility. Watch Video
FAQ About Infertility
Infertility is not an inconvenience; it's a disease of the reproductive system that impairs the body's ability to perform the basic function of reproduction. Learn the facts
FAQ About the Psychological Component of Infertility
Infertility often creates one of the most distressing life crises that a couple has ever experienced together. Learn the facts
Mary Dolan's Story
I was diagnosed with diminished ovarian reserve/premature ovarian failure at 28 years old.
Read the story
Infertility Infographics
ASRM has prepared infographics to illustrate the subject of Infertility better. View the infographicsFind a Health Professional
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