Aqua Scan (Saline Infusion Sonography – SIS): Accurate Uterine Cavity Evaluation with Ultrasound

What Is Aqua Scan (Saline Infusion Sonography – SIS)

Aqua Scan, also known as Saline Infusion Sonography (SIS), is a specialized diagnostic ultrasound examination used for the detailed evaluation of the uterine cavity. It is a modern and minimally invasive procedure during which a small amount of sterile saline solution is infused into the uterus through a thin catheter in order to improve the visibility of the internal uterine structures.

The presence of the fluid gently expands the uterine cavity, allowing the doctor to identify possible abnormalities or structural changes with greater accuracy, including findings that may not always be visible during a standard transvaginal ultrasound. In this way, Aqua Scan provides high-resolution imaging of the endometrium and contributes significantly to accurate diagnosis.

This examination is widely used in fertility investigations, as the normal structure of the uterine cavity is essential for successful embryo implantation. At the same time, it is a valuable diagnostic tool for evaluating gynecological symptoms such as abnormal uterine bleeding, providing reliable information about the anatomy and condition of the uterus.

What Does Aqua Scan Evaluate?

Aqua Scan is a key diagnostic tool for detecting intrauterine abnormalities that may affect fertility or cause gynecological symptoms.

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Through this examination, the following conditions can be identified with high accuracy:

Uterine polyps, which may interfere with embryo implantation
Submucosal fibroids that distort the uterine cavity
Intrauterine adhesions (Asherman syndrome)
Congenital uterine abnormalities (such as uterine septum)

The detailed visualization of the uterine cavity makes Aqua Scan especially valuable in infertility investigations and in planning the most appropriate treatment approach.

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Accurate diagnosis is the first and most important step. With Aqua Scan, you gain a clear understanding of your uterine health and move forward with confidence.

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When Is Aqua Scan Recommended?

Aqua Scan is an essential examination for the detailed evaluation of the uterine cavity, especially when there is suspicion that the structure of the uterus may affect fertility or be associated with gynecological symptoms. It is often used as the next diagnostic step when a standard transvaginal ultrasound cannot provide sufficiently clear findings.

It is mainly recommended in cases such as:

Unexplained infertility, where intrauterine factors affecting implantation need to be excluded
Recurrent miscarriages, in order to identify abnormalities of the uterine cavity such as adhesions or uterine septum
Preparation before In Vitro Fertilization (IVF), to ensure the endometrium is suitable for embryo implantation
Abnormal uterine bleeding, such as bleeding between periods or heavy menstruation, where polyps or fibroids may be suspected
Follow-up or confirmation of findings from previous examinations when greater diagnostic accuracy is required

The timely and appropriate use of Aqua Scan allows the identification of conditions that may affect fertility, contributing to the selection of the most suitable treatment strategy.

How Is the Aqua Scan Examination Performed?

Aqua Scan is a short, safe, and minimally invasive procedure performed in the doctor’s office without the need for anesthesia. Proper timing is essential, which is why the examination is usually scheduled between the 6th and 12th day of the menstrual cycle, after the end of menstruation and before ovulation.

The procedure includes the following steps:

The patient is positioned in a gynecological examination position, similar to a standard ultrasound examination
After an initial transvaginal ultrasound, a thin and flexible catheter is inserted through the cervix
Sterile saline solution is gradually infused into the uterine cavity, gently expanding the uterine walls
At the same time, using transvaginal ultrasound imaging, the doctor monitors the uterus in real time and identifies any abnormalities

The examination lasts approximately 10–15 minutes and is well tolerated by most women. After the procedure, mild discomfort or slight fluid leakage may occur, but no recovery time is required.

Advantages of Aqua Scan

Aqua Scan is considered one of the most reliable and accurate methods for evaluating the uterine cavity, offering significant diagnostic advantages compared to other examinations. The use of saline solution combined with ultrasound imaging allows clear visualization of the uterine walls and possible pathological findings.

The main advantages include:

High diagnostic accuracy in detecting uterine polyps, submucosal fibroids, and intrauterine adhesions
Improved visualization of the uterine cavity compared to standard transvaginal ultrasound
No radiation exposure, making the procedure safe for repeated use
Minimally invasive procedure without the need for anesthesia or medication
Well tolerated by patients, with only mild discomfort during the examination
Immediate return to daily activities without restrictions
Ability to provide immediate evaluation and real-time medical decision-making

The combination of safety, accuracy, and speed makes Aqua Scan an essential tool in the modern approach to infertility evaluation and the diagnosis of uterine conditions.

Frequently asked questions about Aqua Scan (Saline Infusion Sonography – SIS)

Is Aqua Scan a safe examination?

Aqua Scan is considered a highly safe diagnostic examination because it does not use radiation and relies exclusively on ultrasound imaging and sterile saline solution. The procedure is minimally invasive and performed in a controlled medical environment, significantly reducing the risk of complications. In rare cases, mild discomfort or slight bleeding may occur, but these symptoms usually resolve quickly without treatment. The risk of infection is very low and is minimized through proper medical evaluation before the examination.

Is Aqua Scan painful?

Most women describe Aqua Scan as a well-tolerated examination with mild discomfort similar to light menstrual cramps. This sensation is mainly caused by the infusion of saline solution into the uterus and lasts only a few minutes. No anesthesia is required, and after the procedure the patient can immediately return to her daily activities. In cases of increased sensitivity, a mild pain reliever may be recommended before the examination if advised by the doctor.

What is the difference between Aqua Scan and a regular ultrasound?

A standard transvaginal ultrasound provides a general view of the uterus, but in many cases it cannot accurately identify small intrauterine abnormalities. In contrast, Aqua Scan uses saline solution to gently expand the uterine cavity, allowing clearer separation of the uterine walls and improved visualization of possible abnormalities. This means that Aqua Scan can detect uterine polyps, fibroids, or adhesions with greater accuracy than a standard ultrasound.

Can Aqua Scan identify the cause of infertility?

Aqua Scan plays an important role in infertility investigation because it focuses on evaluating the uterine cavity, which is essential for successful embryo implantation. It can identify pathological conditions such as uterine polyps, fibroids, or adhesions that may negatively affect fertility. However, it does not evaluate fallopian tube patency or other infertility factors, which is why it is often part of a comprehensive fertility assessment.

When is the best time to undergo Aqua Scan?

The examination is ideally performed immediately after menstruation and before ovulation, usually between the 6th and 12th day of the menstrual cycle. During this phase, the endometrium is thinner, allowing better visualization, while pregnancy can also be safely excluded. Proper timing is essential for reliable results and is always determined in consultation with the treating physician.

Are there any side effects after Aqua Scan?

After the examination, mild abdominal discomfort, slight fluid leakage, or light spotting may occur. These symptoms are considered normal and usually resolve within a few hours. Serious complications are extremely rare. Patients are advised to contact their doctor if they experience severe pain, fever, or prolonged bleeding, although such cases are uncommon.

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In an era where fertility requires knowledge, care, and substantial guidance, FertUlity is not an impersonal clinic. It is two people who look you in the eye and accompany you step by step on the journey you dream of.

Dr. Chrysostomos (Makis) Papadopoulos Obstetrician – Gynecologist, MD, PhDc, MIC I

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Dr. Chrysostomos Papadopoulos - Specialist in Infertility, Endocrinology & Menopause in Athens

Dr. Maria Oikonomou Obstetrician – Gynecologist

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FertulityThrough the Words of our Parents

100% genuine, public Google reviews.
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      EXCELLENT  
   Based on 12 reviews 
    
 
 
 
   
 
 
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   Μαρια 
 26 days ago
 
 
  The word "thank you" to Dr. Makis Papadopoulos is too small to describe the gratitude we feel for this man. I am pregnant after IVF, having succeeded on the first attempt, and we owe this exclusively to our doctor. First Contact & Communication: From the very first contact, he won us over with his kindness, enthusiasm and willingness to dedicate as much time as we needed. Willing to explain everything in every detail, he solved every question we had in depth — not even a professor to students would analyze them with such patience and contagiousness! Scientific Training: He is an excellent scientist, with deep knowledge of the subject, a perfectionist and focused professional who leaves absolutely nothing to chance. He designed the right treatment for us, solving every problem down to the last detail, making us feel that whatever problem arises, it is certain that it will be solved. HUMANITY & SUPPORT: The most important thing, however, is his humanity. Communication with him was Immediate and he always had as much time as you needed on the phone to solve every question. He showed a deep, real interest, embracing us not just as a doctor, but as if he were our brother. We highly recommend him to every couple starting this journey. He deserves blind trust! We thank you from the bottom of our hearts for the greatest miracle of our lives!

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   Alexandra 
 52 days ago
 
 
  I don't often write reviews, but I feel that Mr. Makis truly deserves it. From the very first moment, he made me feel safe and confident. He listened carefully to what was on my mind, answered every question I had, and explained everything in a simple way, always based on scientific data. Many times, he even sent me relevant scientific studies so that I could better understand why he was suggesting a particular approach. But what stood out to me the most was that he didn't stop at the appointment. He followed up, was genuinely interested in my progress, and was available when I needed him. This is something you rarely encounter. Fortunately, he returned to Greece. He is one of the few doctors who, beyond their knowledge, remain above all human beings. He makes you feel like he sees you as a person and not as just another incident.

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   Matina 
 69 days ago
 
 
  A big thank you to Dr. Makis Papadopoulos who supported us from day one, who checked every little detail, who explained to us every move-step, every test, every medication for the reason we were doing it and what we would achieve. With incredible experience, knowledge, a lot of patience (because we had two other failed attempts with another doctor) and trust, within 8 months he adapted the protocols for our case and we achieved the positive result and we hold in our arms a priceless diamond. Above all, a rare person, calm and always available to listen to our concerns and reassure us. I highly recommend him!

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   Eva 
 93 days ago
 
 
  Thanks to Dr Makis Papadopoulos, I am now holding my two beautiful babies in my arms! He is a true expert. Professional with a human centric approach, friendly and empathetic, always available to answer our (many many) questions. I trust Dr Makis blindly and, honestly, I cannot recommend him enough!
  
 
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   Ivy 
 100 days ago
 
 
  My experience with Dr. Makis took me from a clinical stagnation to an incredible breakthrough, highly recommend Dr. Makis! Navigating the exhausting world of IVF, you know how devastating it is to watch your protocol dosages go up while your results go down. After three intense, high-dosage cycles with a previous clinic, I was left feeling incredibly discouraged. Despite escalating medications and growth hormones, my blastocyst yield was dwindling, culminating in a heartbreaking round with zero blastocysts. I knew I needed a doctor who didn't just follow a standard script, but who truly understood the nuances of egg quality and customized protocols. That is when I found Dr. Makis. Dr. Makis completely revolutionized my treatment plan. Instead of just pushing maximum dosages, he took a highly strategic, tailored approach. The result? Quality over pure protocol size. While my previous doctors kept increasing the medication dosages (which yielded fewer or zero blastocysts), Dr. Makis completely changed the strategy. He lowered the heavy stimulation, introduced smart egg-quality support (like melatonin), changed the protocol style entirely, and achieved a 700% increase in blastocysts compared to my best previous rounds. Beyond the incredible results, Dr. Makis brings a level of expertise, precision, and reassuring care that is rare to find. He looks at you as an individual, not a statistic, and knows exactly how to pivot when traditional routes fail. If you are looking for a specialist who can turn a difficult prognosis into an overwhelming success, look no further than Dr. Makis. I am incredibly grateful for his care.
  
 
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   Olga 
 111 days ago
 
 
  Dr. Makis Papadopoulos was excellent, professional, and very reassuring throughout the entire process. Thanks to his expertise and guidance, we were able to identify the issue early and take the appropriate steps from the beginning. He took the time to explain everything clearly, answered all our questions with patience, and made us feel comfortable and confident throughout our journey. We truly appreciated his caring approach, professionalism, and dedication. Highly recommended!
  
 
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   Euaggelia 
 122 days ago
 
 
  Dr. Makis Papadopoulos is an excellent scientist and above all a rare person! He is an approachable and smiling doctor, with excellent medical knowledge, who from the first moment I met him made me feel comfortable and trust him completely, answering every question I had with patience and documenting every answer with scientific studies and articles! The most important thing, however, is that Dr. Makis Papadopoulos is always there on the other end of the line to listen to you and reassure you without a trace of haste, a doctor who truly cares and makes you feel like he is your own person! Makis, thank you very much for everything!!! I am very lucky to have met you!

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   Anastasia 
 129 days ago
 
 
  Dr. Makis Papadopoulos is an excellent scientist with a human-centered interest. Our collaboration was excellent from the very beginning and he made me feel confident and secure by explaining every step of the process in great detail. I highly recommend him!

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   Fay 
 131 days ago
 
 
  Dr Makis Papadopoulos is very professional, caring and attentive. Very thorough in explaining the whole process throughout every step. Thank you! Highly recommended!!
  
 
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   Christina 
 134 days ago
 
 
  I would like to share my experience with Dr. Makis Papadopoulos, an outstanding gynecologist and scientist. We first connected in the summer of 2024, while he was based in Germany, through a mutual acquaintance, following a particularly challenging period for us. Prior to meeting him, we had gone through repeated unsuccessful attempts of stimulation and fertilization with other gynecologists. Unfortunately, those approaches relied largely on standardized protocols, without sufficient personalization to address the specific needs of my case. From the very beginning, Dr. Makis stood out for his human-centered approach and his willingness to dedicate time to truly understand our situation in depth. With strong, up-to-date scientific knowledge, he approaches every case holistically, focusing on individualized treatment and adapting protocols to the patient's unique needs. Throughout our collaboration, which now spans approximately two years (with a few breaks on our side), he has consistently been available, supportive, and clear in his guidance. He inspired confidence and helped us stay positive even during difficult phases of the journey. Beyond his scientific expertise, what truly sets him apart is his genuine care for the person behind each case: his empathy, honesty, and continuous effort to achieve the best possible outcome. My husband and I are deeply grateful for his support and guidance, and we now feel ready and optimistic to move forward to the next final stage. We highly recommend him to anyone seeking a gynecologist with true expertise, professionalism, and compassion. I would like to share my experience with Dr. Makis Papadopoulos, an excellent gynecologist and scientist. We met in the summer of 2024, when he was in Germany, through a mutual acquaintance, after a particularly demanding period for us. Before meeting him, we had gone through repeated failed attempts at stimulation and fertilization with other gynecologists. Unfortunately, the approaches that had been followed were mainly based on standardized protocols, without the necessary individualization to the specifics of my case. From the beginning, Dr. Makis stood out for his human approach and his willingness to spend time to understand our case in depth. With modern knowledge and scientific training, he approaches each issue multidimensionally, emphasizing the individualization of treatment and adapting the protocols to the real needs of the patient. During our collaboration, which now spans about two years (with short breaks on our part), he was always available, supportive and clear in his guidance. He inspired confidence in us and helped us remain optimistic even in difficult phases. In addition to his scientific competence, what sets him apart is his genuine interest in the person behind each case: his empathy, his honesty and his constant effort to achieve the best possible outcome. My husband and I thank him warmly for his support and guidance and we now feel ready and optimistic to move on to the next final stage. We highly recommend him to anyone looking for a gynecologist with real knowledge, professionalism and humanity.

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   Faidra 
 135 days ago
 
 
  Dr. Makis Papadopoulos is an excellent gynecologist and above all an excellent person! I truly thank him for his support and care during the egg freezing process. Although my case was particularly demanding, he stood by me with patience, knowledge, great experience and real interest. Our communication was direct and human, while his availability at the many appointments made me feel safe at every step. The protocols were designed specifically for me, aiming for the best possible result, while also taking into account the cost of the medications. I recommend him with all my heart to every woman who wants to trust someone for something so important and sensitive for her.

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   Iliana 
 137 days ago
 
 
  I highly recommend Dr. Makis, he is an incredible specialist. My journey was far from easy, encountering several challenges that  made the process feel overwhelming at times. What sets him apart is his willingness to go beyond standard procedures. He developed a specialized, custom protocol, tailored to my situation, which ultimately made all the difference. Beyond his technical expertise, his calm and clear communication kept me grounded throughout the process. I am so grateful for his persistence and high level of care!

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Because every fertility journey deserves the right support. At FertUlity, we provide science-based fertility care with a human approach. We support every path, from fertility assessment and preservation to modern assisted reproduction.

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