SIS is used to identify potential abnormalities within the uterus that may be affecting implantation or cause other fertility problems. This can include conditions such as:

• Uterine fibroids: These are non-cancerous growths that can develop in the uterine wall. These growths can sometimes interfere with implantation or cause irregular bleeding.
• Uterine polyps: These are small growths that can form in the lining of the uterus. Polyps can also affect fertility and cause abnormal bleeding.
• Uterine adhesions: Scar tissue can form within the uterus, often as a result of surgery, infection, or endometriosis. Adhesions can block the fallopian tubes or interfere with implantation.
• Uterine septums: This is a congenital anomaly where a fibrous or muscular tissue divides the uterine cavity, creating two sections. This condition occurs when the uterus does not fully develop during fetal growth, leading to the formation of a septum—a wall that separates the two sides of the uterus. This can lead to many different infertility issues including recurrent pregnancy loss (RPL).

The procedure is quick, usually lasting about 10–15 minutes, with minimal discomfort. It does not involve the use of anesthesia and is performed at our clinic. 

Here is what to expect with an SIS procedure.

• Preparation: The test is typically planned for the days after your period ends. No other preparation is required for this exam, and you can eat and drink as usual on the day of the exam. You may be advised to take Ibuprofen or Tylenol before the procedure to minimize any potential discomfort. You will be asked to empty your bladder before the procedure begins.
• Vaginal Ultrasound: The first step during this test involves a transvaginal ultrasound. For this, a transducer wand is inserted into the vagina to get images of your uterus.
• Saline Infusion: A thin tube (catheter) is inserted through the cervix into the uterus, and a sterile saline solution is slowly introduced.
• Imaging: When enough saline fluid fills your uterus, images are taken of the inside of your uterus, allowing for a detailed examination of the uterine cavity.
• Post-Procedure: Once sufficient images are taken, the wand and catheter are removed. The saline fluid will drain out of your uterus over the next few hours. You may use a sanitary or absorbent pad in your underwear during this period.

The primary purpose of HyCoSy is to determine whether the fallopian tubes are open or blocked. This is crucial for fertility because the fallopian tubes are the pathway for the egg to travel from the ovary to the uterus and for the sperm to reach the egg for fertilization.

The HyCoSy assessment is a minimally invasive procedure that does not require surgery or anesthesia. It is relatively quick, typically taking 10-15 minutes. You may experience mild discomfort or none at all.

Here is what to expect with the HyCoSy test:

• Preparation: Similar to the SIS, this is an internal scan; you do not need any special preparation. You may be asked to empty your bladder before the scan. You may also be asked to take Ibuprofen or Tylenol before the procedure.
• Vaginal Ultrasound: The scan is performed using a transvaginal ultrasound. For this, a transducer wand is inserted into the vagina to get images of your uterus. 
• Cleaning the Cervix: Next, just like with a pap smear, a speculum is inserted into the vagina, and the cervix is cleaned with an antiseptic. Then, a thin tube, or catheter, is passed through the cervix into the uterus. The transducer wand replaces the speculum.
• Contrast Agent Injection: When performed along with the SIS, the uterus is then injected with a sterile saline solution to assess the uterus. Following this, a contrast agent similar to water with bubbles is injected into the uterus through a thin tube.
• Imaging: We use the ultrasound wand to generate images of the uterus and fallopian tubes as the contrast agent moves through the reproductive system. If the fallopian tubes are open and unblocked, the imaging will show the fluid passing through the tubes and flowing around the ovaries.

At Perch Fertility, we often perform SIS and HyCoSy at the same time to provide a complete evaluation in just one visit. This combined approach allows for a comprehensive assessment of both the uterine cavity and fallopian tubes, minimizing your time spent in the clinic and ensuring you get the most accurate and efficient results.

A hysteroscopy provides highly detailed images and can help diagnose conditions such as endometrial polyps, fibroids, or adhesions. In certain cases, hysteroscopy may also be used in a therapeutic capacity to remove polyps or adhesions during the procedure.

Hysteroscopy is often recommended when other diagnostic tests, such as SIS or HyCoSy, suggest potential abnormalities in the uterine cavity. It may also be used to investigate unexplained infertility or abnormal bleeding.

The procedure is performed either awake or under light anesthesia and involves minimal discomfort. Hysteroscopy can be used to both diagnose and treat certain uterine conditions. We may perform diagnostic and operative hysteroscopy at the same time, eliminating the need for a second surgical procedure. 

Here is what to expect with a hysteroscopy:

• Preparation: You may be given anesthesia to ensure comfort during the procedure. This means that you may be advised to fast before the procedure. Our team will provide you with pre-procedure guidelines. For the best view of your uterus, the test is best performed in the days after your period and before your next ovulation cycle.
• Procedure: During the procedure, a thin, lighted tube with a camera (hysteroscope) is inserted into the vagina and uterus. The camera provides a clear view of the uterine cavity. In some cases, we may take tissue samples (biopsies) or remove uterine polyps during the scan. This helps remove abnormalities that may be causing abnormal uterine bleeding.
• Recovery: Hysteroscopy is typically performed on an outpatient basis, and recovery time is generally short. Since the procedure is sometimes performed under anesthesia, we recommend you arrange for transportation after. You may experience some cramping or spotting for a few days after the procedure.