A sonohysterogram is an ultrasound technique in which a small amount of saline solution is injected into the uterus, allowing us to see images of the uterus and its lining, and to confirm whether the fallopian tubes are open. Some clinics may refer to it as SHG or simply “sono.” It is part of a series of medical tests to determine fertility factors and takes about 15 minutes. Doctors will say it’s painless and for the most part it is. It’s a minimally invasive test that only requires taking 1-2 pain relieving pill(s) an hour prior. (At some clinics, a smear may also be taken at this time if a pap test is due.)
Is it comfortable? I don’t think anytime that we are lying on our back with our legs open for a doctor to perform a test can we say it is comfortable. But this one in particular can be unnerving. First, there will be a sensation of an instrument being inserted into the vagina to pry it open (the speculum). On a lucky day, it will be at room temperature or warm. After that, it will feel like something is going really deep inside the body (the catheter) and then the pinching will start (the injection). For me, it always feels like something is trying to pinch my uterus downwards. This will be the height of discomfort. Once this is done, everything is quickly removed and the transducer is inserted for the images.
My first sono experience was meh. We didn’t start off well since the speculum was cold. I had been breathing steadily the entire time, but when the pinching sensation began I felt panic emerging. This is when I switched to long, deep belly breathing to contain the anxiety. And this unfortunately did not help. The more the belly moves, the shakier the pelvis becomes. I’ll take a guess here that this only slows down the procedure. I remember when I inflated my belly with a deep inhale, the imaging technician would try to press it back down, which only increased my anxiety. I mean, they could’ve given me a quick moment to recollect myself but okay.
On my second round, I opted for lateral breathing and this made all the difference. It went by really fast! Lateral breathing (or what I like to call “breathing into the ribcage”) will keep the breath steady, without as much emphasis on the belly. It is a conscious breath that may feel a little like the breath we fall into during deep relaxation or sleep. That’s really what we are aiming for: remaining calm. It’s also a good breathing technique to use on the day-to-day or even when participating in physical activity. Yes, including yoga (try ujjayi with a lateral breath and see how it feels). Here is how we can differentiate between belly breathing and lateral breathing when lying down (since the sono is done in supine position).
Belly breathing: Lie down comfortably on your back and place both hands over your stomach. As you inhale deeply, feel the rise of your belly lifting your hands. As you exhale long, feel your hands lowering as the belly falls. Continue to breathe, observing the rise and fall of the belly. Take five deep belly breaths in this way. Lateral breathing: Lie down comfortably on your back and place your hands on either side of the body, fingers feeling the ribcage. As you inhale, focus on expanding the ribcage, pushing the fingers away from the body. As you exhale, allow the ribcage to return to its natural position, bringing the hands closer together. You might find that lateral breathing is not as "deep" as belly breathing. That's okay. Instead of a deep breath, focus on a steady breath. Take five more breaths.
If you are not used to lateral breathing, it’s a good idea to practice a few times before your sono appointment. It took me awhile and I still have to observe myself to consciously do it. Another tip: bring a pad to wear after the test. Saline solution will leak out and spotting may occur. You can also expect very mild cramping.