Saline Ultrasound or Endometrial Biopsy: What Does Each Test Tell You?

If the clinic has offered another test after you described bleeding, the names can make it hard to picture the next appointment. Write down the proposed test and ask what question it is meant to answer before arranging your day around it.

Saline helps outline the uterine cavity

During sonohysterography, sterile saline passes through a small catheter into the uterus while ultrasound images are taken. It can show details of abnormalities such as polyps or fibroids that may be less clear on routine transvaginal ultrasound. This is imaging rather than tissue sampling.¹

Ask which finding the clinician wants to see more clearly. RadiologyInfo explains that the radiologist sends a report to the referring doctor, who shares the results. Confirm who will explain yours and whether the findings could lead to another investigation.¹

A biopsy sends a sample to the laboratory

An endometrial biopsy collects tissue from the uterine lining through the cervix. Gloucestershire’s guidance describes laboratory examination for abnormalities, including abnormal cells or signs of cancer. The result helps the doctor choose appropriate treatment; ask what finding prompted the recommendation in your case.²

The NHS³ explains that biopsy results can take weeks, with timing varying between hospitals and by the reason for testing. A clinician should explain the result and what comes next. Ask when to contact the service if you have not heard.³

Discuss preparation and comfort for the named test

Sonohysterography should not be performed during pregnancy or active pelvic inflammatory disease. Timing often relates to the menstrual cycle, but can vary with symptoms. Tell the team if pregnancy is possible and ask how to book if your bleeding is irregular.¹

For biopsy, ask about pain relief and the clinic’s aftercare instructions. The NHS³ notes that womb biopsies can cause cramps or light bleeding. Pain that worsens or does not respond to painkillers, or a high temperature, needs urgent medical advice.³

Keep the test name, preparation instructions and contact details together. You can ask the clinic to explain whether you need one test, both, or a different next step before agreeing to the plan.

Period, Handled includes a Period Scorecard and visit script. Use them to organize bleeding observations and questions alongside your investigation plan. See the book.