Key Points

• Sonohysterography (SHG) comprises the transcervical instillation of sonographic contrast and simultaneous ultrasound evaluation to facilitate the evaluation of the endometrial cavity
• Contrast can be either gel (gel infusion sonography or GIS), or saline (saline infusion sonography SIS) and may be instilled via a simple insemination catheter, a endometrial biopsy cannula with an appropriate connector,  or by a specially designed device typically fitted with a balloon to prevent egress of media.
• SHG can and should be performed in the office by a gynecologist, preferably with transvaginal ultrasound
• For women who are virginal, SHG will not be feasible making alternative approaches to endometrial cavity assessment necessary.