May 31, 2020

What to Know When Your Ob/Gyn Recommends Saline Infusion Sonography

A closer look at getting a SIS

woman in doctor's office finding out about SIS procedure

If you’ve ever experienced irregular, heavy or post-menopausal bleeding, struggle with infertility or had an ultrasound and something came up abnormal, or the cavity was not clearly seen, your doctor could order a saline infusion sonography (SIS). This special ultrasound gives your doctor a better look at your uterus, especially the cavity.

Advertisement

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

What exactly is a SIS and what does it involve? Gynecologist Oluwatosin Goje, MD, explains all the nuances that come with getting a SIS.

A closer look

The procedure itself goes quickly and usually doesn’t hurt, says Dr. Goje.

A SIS is similar to the transvaginal ultrasound that’s often performed, but with one added step: Sterile fluid is used to gently expand and hold the walls of your uterus apart. This helps your doctor get a better view of the uterine cavity and any irregularities can be seen more clearly. It can also show whether there are any polyps, or abnormal tissue growths, extending inside the uterus, any fibroids pressing on the lining and whether the uterine cavity is normally shaped.

Your doctor will order a SIS for you if you:

Advertisement
  • Had an ultrasound that was inconclusive and more views are needed
  • Struggle with infertility.
  • Have pelvic pain.
  • Have two or more miscarriages in a row.
  • Abnormal menstrual cramps.
  • Will be having IVF treatment.
  • Experience irregular or heavy and they are considering polyps or fibroids postmenopausal bleeding.

“A SIS is a very safe procedure and complications from the procedure are rare,” says Dr. Goje. “You may feel a slight discomfort when the fluid is gently introduced into the uterine cavity. The most common complication is pelvic infection, but this is rare.”

There isn’t much you have to do to prepare for a SIS. To avoid accidentally doing the procedure in early pregnancy, Dr. Goje recommends getting it done after your period ends but before you ovulate.

“A SIS is performed between day 6 to 11, considering the first day of menstrual bleeding as day 1,” says Dr. Goje.

If you’re pregnant, your doctor won’t schedule a SIS for you.

Advertisement

Your doctor may suggest you take acetaminophen or ibuprofen (Advil®, Motrin®) before the procedure. But if you prefer a different medication or have allergic reactions to the listed medications, talk to them about your options.

5 things to expect during the procedure:

  1. First, a sterile speculum is placed in the vagina, just like for a Pap test. The cervix is visualized and the cervix and vagina are cleaned off with a soap solution. Then, a soft flexible tube, thinner than the inside of a pen, is passed into the uterus via the cervix. Most people don’t feel this at all while some feel it minimally. Sometimes your doctor may provide a medication in advance to soften the cervix in post-menopausal women for ease of passage of soft flexible tube.
  2. The speculum is removed and the ultrasound probe inserted. While the ultrasonographer takes images of the uterus, sterile liquid is gently injected through the thin tube, or catheter. You may feel a little bloating or cramping, but most women don’t feel much.
  3. After the pictures are recorded, the probe and the catheter slip right out.
  4. When you sit up after the procedure, you’ll probably feel lots of water coming out onto the sheet you are sitting on. Many patients wear a pad home, just in case there is any further dripping. Sometimes fluid may be blood-tinged or pink in color due to the disruption of the lining or wall of the uterus. This is usually self-limited.
  5. The results of the scan are shared with the referring doctor, who will use them to make a treatment plan for your specific situation.

A SIS will be able to help you be on your way toward the best treatment for you. Talk to your doctor to figure out if scheduling a SIS is your best option.

Learn more about our editorial process.

Related Articles

Female sitting on couch at home fanning their face from hot flash
March 28, 2024
Does Having Hot Flashes Mean I’ve Started Menopause?

These heat waves can actually start in perimenopause, which can begin up to a decade earlier

Female clutching abdomen
March 14, 2024
Period Blood Clots: Should You Be Concerned?

Although it can be alarming, it’s normal to experience blood clots during menstruation

Birth control pack, with an overlay of a hand holding other pills and tablets
March 13, 2024
What Medications Interfere With Birth Control Pills?

Certain seizure medications, HIV treatments, antibiotics or herbal supplements can make your oral contraception less effective

Female patient at doctor office discussing concerns and issues
March 12, 2024
Bleeding Between Periods? How To Tell if It’s a Problem

Reasons for spotting can include menopause, uterine fibroids, PCOS and birth control

doctor speaking with middle-age woman
February 21, 2024
Does Your Health Determine Menopause Age?

Reaching menopause very early raises your risk of certain health conditions

Female speaking with doctor, with uterus and ovary with cysts
February 21, 2024
Can PCOS Cause Weight Gain?

The common hormonal condition is linked to insulin resistance, which can cause weight gain

Older woman awake in bed in the middle of the night looking a smartphone
February 20, 2024
Does Menopause Cause Insomnia and Sleeplessness?

Hormone changes can definitely leave you tossing and turning at night, but help is available

Teal awareness ribbon in doctor's hand, symbolic bow color for supporting patient with PCOS
February 7, 2024
Is Polycystic Ovarian Syndrome Genetic?

While this hormonal condition can be hereditary, there are other risk factors to also consider

Trending Topics

Person in yellow tshirt and blue jeans relaxing on green couch in living room reading texts on their phone.
Here’s How Many Calories You Naturally Burn in a Day

Your metabolism may torch 1,300 to 2,000 calories daily with no activity

person getting a sinus massage between brows
5 Sinus Massage Techniques To Relieve Pressure and Promote Drainage

A gentle touch in all the right places may help drain your sinuses

woman snacking on raisins and nuts
52 Foods High In Iron

Pump up your iron intake with foods like tuna, tofu and turkey

Ad