Abstract Objectives: Sonohysterography is a well-known accurate method for the assessment of uterine cavity and tubal patency with high positive predictive value in the investigation of infertility .This procedure in usually done in tertiary centres where our rural infertility patients reaches at a late stage losing the golden period of treatment. Our goal was to study simplicity, safety, adverse effects, complications of sonohysterography when done with combined use of acetaminophen, atropine, dicyclomine, doxycycline and agitated saline and also to study the feasibility to do cervical screening as per NICE and WHO guidelines. Methods: This study was based on cervical screening done by Pap smear and evaluation of tubal patency done by sonohysterography in 54 patients. All patients underwent clinical evaluation on first visit and Pap smear and sonohysterogram is performed in the early follicular phase. Results: Among 54 infertile women who had tubal factor as the cause of their infertility underwent pap screening and sonohysterography. In 49 patients (90%), at least one tube was shown to be patent, 5 were shown to have bilateral tubal block. 5 patient’s undergonelaparoscopy of which 2 were found to have patent tube. No patients had severe vasovagal reactions, mild vasovagal reactions such as sweating, weakness, nausea and vomiting generally happened. 46 patients had mild pain (85%), 9 patients had moderate pain (15%). Two patients had cramps during procedure which settled in 10 to 20 minutes. None had perforation of uterus. Most common post procedure side effect was a small amount of vaginal bleeding, which usually disappeared in 3 days. Pap smear reported negative for intraepithelial lesion or malignancy in all, and bacterial vaginosis in 7, fungal organisms morphologically consistent with candida spp. in 5, and trichomonas vaginalis in 2. Conclusion: Sonohysterography is an accurate method for the determination of fallopian tube patency and helps in identifying intrauterine pathology. It is a very cheap, cost effective, simple, safe, well-tolerated technique with very low risk of adverse side effects and complications. Use of atropine, analgesics, antibiotic and day care procedure makes it friendly for both doctors and patients. Screening cervix with counselling will help a long way for decreasing the morbidity and mortality due to carcinoma cervix in a developing country like India where we have 83 percent population in rural area.

Keywords: Sonohysterography (SHG), hysterosalpingography (HSG), Chlamydia Antibody Titre (CAT), infertility, laparoscopy, tubal factor, Pap smear.