What is hysterosalpingography?
A hysterosalpingogram or HSG test allows the fertility specialist to examine the inner walls of the uterus and fallopian tubes. This minor procedure is designed to provide information about the shape and contour of the endometrial cavity (uterus) and document the presence of endometrial polyps, leiomyomas (fibroids), or scarring. In addition, the procedure determines whether the fallopian tubes are open. Blocked fallopian tubes, or a possible growth in the uterus, can reduce the chances of pregnancy. If the fallopian tubes are blocked, the sperm cannot reach the egg. A hysterosalpingogram, or HSG test, uses X-rays and a special dye to look for scar tissue, polyps, fibroids, and other growths that may be blocking the tubes or preventing a fertilized egg from implanting properly in the uterus.
Another test, called an ultrasound, uses ultrasound and a special solution to detect abnormalities inside the uterus. However, ultrasound cannot be used to detect blocked fallopian tubes. An HSG is routinely performed as part of an infertility test.
What should I expect during an HSG test?
An HSG test takes between 10 and 30 minutes. The doctor inserts a speculum into the vagina (like when you have a Pap smear) and then places a thin plastic tube into the cervix, which leads to the uterus and fallopian tubes. A special dye is injected through the plastic tube. The dye should fill the uterus and fallopian tubes and spill out of each fallopian tube. X-rays are then taken, with which the doctor can evaluate the uterus and fallopian tubes.
Is the HSG procedure painful?
Many women feel some cramping, especially when the dye is injected. Women who have a blocked fallopian tube may experience severe pain. Over-the-counter pain relievers, such as ibuprofen, can help relieve this pain or discomfort. Talk to your doctor about taking pain medication 30 to 60 minutes before the procedure to prevent or reduce pain during the test. Many women don't have pain after HSG, but you may experience cramping or pain after the procedure, so it's a good idea to have someone drive you home.
What are the risks or possible side effects of a hysterosalpingogram?
Risks of HSG include:
- Pain or discomfort
- Vaginal spotting or bleeding
Contact your doctor if you develop:
→ Heavy bleeding
→ Intense pain in the lower abdomen
→ Foul-smelling discharge
In rare cases, a woman may be allergic to the iodine contrast agent used in an HSG. Patients with documented allergies to iodine, intravenous contrast dyes, or shellfish should inform the physician prior to the procedure.
How should I prepare for hysterosalpingography?
The test should be scheduled after your period ends but before ovulation, usually between days 6 and 10 of the menstrual cycle. To calculate the days of your cycle, count day 1 as the day your period starts. Antibiotics, prescribed by your referring doctor, are given prophylactically to prevent infection and must be taken the day before, the day of the test and the day after.