Saline Scan - Midland Fertility Services

Saline Scan
What is a saline scan?
A saline scan – otherwise known as a
saline infusion sonohysterogram (SIS) - is a
technique developed to assess the uterus,
using ultrasound scanning. It uses sterile
saline (salt water) solution passed through
a catheter (a fine, flexible, sterile,
plastic tube) which has been placed in the
cervix, along with transvaginal
ultrasound.
Why may a saline scan be necessary?
This procedure may be done as
preparation before an IVF cycle, or for
diagnosis of uterine abnormalities as part
of investigations into recurrent
miscarriage. The saline gently distends
(ie swells) the cavity of the uterus and
provides a clearer ultrasound image of:
the lining of the uterus (the
endometrium)
any abnormality that may be related
to the lining
the contour of the endometrial
cavity, detecting conditions such as a
uterine septum or bicornuate uterus
(types of congenital uterine
anomalies)
the interior of the uterine cavity,
detecting non-malignant uterine
growths - eg polyps or uterine fibroids
- which may develop in the cavity and
create an environment that is hostile
to embryo implantation
any scar tissue inside the uterine
cavity may also be identified (eg
Asherman’s Syndrome)
When is the best time to have the
procedure?
The best time to perform a saline scan is
just after the woman’s period has
finished, approximately day seven to day
10 of a regular 28-day menstrual cycle. If
her menstrual cycle is shorter than 28
days, she will need to have the scan soon
after the end of her period. If her periods
are infrequent or irregular, the clinical
team will advise on the best time for the
procedure.
Preparing for the procedure
The patient:
will have a routine urine pregnancy
test at MFS before the procedure. If
she is pregnant, the saline scan is not
required
may eat and drink normally before
the procedure
does not need to empty her bladder
before the procedure
should wear comfortable clothing
that gives easy access to the lower
part of her body
should bring a sanitary towel with her
for use after the scan
How is the procedure performed?
A saline scan is not a painful procedure
and although the patient may experience
some discomfort, no anaesthesia is
required. Much of the procedure is
similar to an embryo transfer:
a speculum is gently inserted into the
vagina so the cervix can be seen
the cervix is cleaned with sterile
gauze
a thin flexible catheter is inserted
through the opening of the cervix, so
the catheter lies within the
endometrial cavity. Inserting the
catheter does not usually cause
discomfort
saline filling the
endometrial cavity
uterus
ultrasound probe
sonohysterogram
catheter
Sterile saline is passed into the endometrial cavity through the
catheter and an ultrasound probe captures an image of the
uterus. (Permission for use granted by Cook Medical
Incorporated, Bloomington, Indiana)
the speculum is removed and the
catheter remains inside while the
ultrasound probe creates an image of
the uterus
a small amount of sterile saline
(approximately 10-20ml) is passed
into the endometrial cavity through
the catheter
the saline distends the endometrial
cavity, allowing better assessment of
the shape of the endometrium
the transvaginal ultrasound probe and
catheter are removed at the end of
the test
© (2013) Midland Fertility Services / 2,15 saline scan v01-06/2013 page 1 of 2

After the procedure
The patient should:
wear a sanitary towel (not a tampon)
be able to drive and resume normal daily
activities
eat and drink normally
take the antibiotics prescribed by MFS (see
below)
What are the risks?
There is a small risk that any infection within the
cervix may spread to the uterine cavity during the
procedure. After the procedure the patient should
take the antibiotics MFS will prescribe for her, as
directed, to minimise this risk. She should contact
MFS immediately if she experiences any of the
following symptoms within a few days of the scan:
unexplained fever
persistent bleeding or foul-smelling vaginal
discharge
increasing lower abdominal pain
feeling generally unwell
Costs
Please refer to the current List of Charges in either
the Patient Finance Information leaflet or via
www.midlandfertility.com/fees.
Further information
Please visit www.midlandfertility.com and search for
‘Saline Scan’.
Is pain relief needed after the procedure?
Most women experience either discomfort or mild
cramping period-type discomfort during the scan. If
necessary, the MFS clinical team will provide pain
relief for the patient before she leaves MFS.
Afterwards, if required, she may take over-thecounter
painkillers, as directed on the packs, such
as:
paracetamol with codeine
ibuprofen
When are the results available?
The member of the MFS clinical team who does the
scan will discuss the results with the patient once
the procedure is complete. They will advise on the
need for any further investigations and procedures or
whether fertility treatment may begin.
What is included in the cost?
the saline scan
What is not included in the cost?
any other clinical or laboratory procedures,
fertility investigations, treatments or
preservation services for either partner
Success rates
The saline scan is a diagnostic procedure, not a
treatment, and so success rates are not relevant.
For treatment success rates, please refer to
www.midlandfertility.com/success-rates for the
most recent published results.
© (2013) Midland Fertility Services / 2,15 saline scan v01-06/2013 page 2 of 2