Fertility Testing & Diagnosis in San Diego

What is a SIS procedure? 

SIS is a test where a small volume of saline (salt water) is inserted into the uterus (or womb). This allows the lining of the uterus (endometrium) to be clearly seen on a transvaginal ultrasound scan. It is also known as a saline ultrasound uterine scan. SIS is an outpatient procedure that is completed in the comfort of the clinic and usually takes less than 15 minutes to perform. It is usually done after the menstrual period ends but before ovulation.

Before: Your SIS test should be scheduled during the first half of your menstrual cycle. Your physician will be prescribing antibiotics prior to the procedure.

During: To start the test, an ultrasound probe is inserted into the vagina to look at your anatomy in more detail.

• Your doctor will then place a speculum inside the vagina (just like for a pap test), clean your cervix, and a thin catheter will be inserted into your uterine cavity. 
• Your doctor will then deliver saline to look at your uterine cavity as part of your infertility work-up. 
• The results of the test are available to you immediately and your doctor can discuss possible next steps within the same visit.

After: Mild cramping and leaking of blood tinged fluid can sometimes be experienced after the test.

Is it uncomfortable?

The SIS procedure may be associated with temporary mild to moderate cramping as the solution is instilled into the uterus, but it is not generally painful. The actual saline infusion usually lasts 1 to 2 minutes. Patients are instructed to remain lying flat for 5 to 10 minutes following the procedure. An SIS is thought to be better tolerated than a hysterosalpingogram (HSG). These symptoms can be greatly reduced by taking medications, as directed before the procedure.

What are the risks and complications of the procedure?

SIS is considered a very safe procedure. However, there is a set of recognized complications, some serious, which occur less than 1% of the time.

Infection: The most common risk is pelvic infection. This usually occurs when a woman has had a previous tubal disease (such as a past Chlamydia infection). In rare cases, infection can damage the fallopian tubes or make it necessary to remove them. You should call your doctor if you experience increasing pain or a fever within 1-2 days of the procedure. You are given antibiotics prior to the procedure to help prevent infection. 

Fainting: Rarely, you may get light-headed during or shortly after the procedure. 

Allergy: You should inform your doctor if you are allergic to iodine or seafood. A different disinfecting agent will be used for those allergic to iodine. If you experience a rash, itching, or swelling after the procedure, you should contact your doctor. 

Spotting: Spotting sometimes occurs for 1-2 days after the procedure. Notify your Doctor if you experience heavy bleeding after.

What is the next step if my test is abnormal? 

If your physician sees any abnormalities, they will likely recommend a surgical procedure, hysteroscopy, and use a camera to further evaluate and/or remove any polyps or abnormal tissue.

Images of SIS:  Saline in the uterine cavity looks like black or “empty” space. A fibroid (benign tumor) can be seen in the image on the bottom.

• Your fertility testing results will tell your doctor the number of sperm in your semen (your sperm count), whether they are normally shaped (morphology), and how well they swim (motility).
• For more information or to schedule your free consultation, go here