HYSTEROSALPIGOGRAM: WHAT TO EXPECT WHEN YOU HAVE THIS TEST

What is hysterosalpingography?

A hysterosalpingogram, or HSG test, allows the reproductive specialist to examine the inner walls of the uterus and the fallopian tubes. This minor procedure is designed to provide information about the shape and outline of the endometrial cavity (the uterus) and to document the presence of endometrial polyps, leiomyomas (fibroids) or scarring. In addition, the procedure determines whether the fallopian tubes are open. Blocked tubes or a possible growth in the uterus can reduce the chances of pregnancy. If the tubes are blocked, sperm cannot reach the egg. A hysterosalpingogram, or HSG test, uses X-rays and a special contrast dye to detect scar tissue, polyps, fibroids and other growths that may block the tubes or prevent a fertilised egg from implanting properly in the uterus.

Another test, called a sonohysterogram, uses ultrasound and a special solution to detect abnormalities inside the uterus. However, a sonohysterogram cannot be used to detect blocked fallopian tubes. An HSG is routinely performed as part of an infertility work-up.

What should I expect during an HSG test?

An HSG test takes 10 to 30 minutes. The doctor inserts a speculum into the vagina (as when you have a smear test) and then places a thin plastic tube into the cervix, which leads to the uterus and the fallopian tubes. A special dye is injected through the plastic tube. The dye should fill the uterus and the fallopian tubes and spill out of each tube. X-rays are then taken, from which the doctor can assess the uterus and the 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 feel severe pain. Over-the-counter painkillers, such as ibuprofen, can help relieve this pain or discomfort. Talk to your doctor about taking painkillers 30 to 60 minutes before the procedure to prevent or reduce pain during the test. Many women have no pain after an HSG, but you may feel cramping or pain after the procedure, so it is a good idea to have someone else drive you home.

What are the risks or possible side effects of a hysterosalpingogram?

The risks of an HSG include:

• Pain or discomfort
• Infection
• Vaginal spotting or bleeding

Contact your doctor if you develop:

→ A fever

→ Heavy bleeding

→ Severe pain in the lower abdomen

→ Foul-smelling discharge

IMPORTANT NOTE:

In rare cases, a woman may be allergic to the iodine contrast medium used in an HSG. Patients with documented allergies to iodine, intravenous contrast dyes or shellfish should inform the doctor before the procedure.

How should I prepare for a hysterosalpingography?

The test should be scheduled after your period has finished but before ovulation, usually between day 6 and day 10 of the menstrual cycle. To work out the days of your cycle, count the day your period starts as day 1. Antibiotics, prescribed by your referring doctor, are given preventively to prevent infection and should be taken the day before, the day of the test and the day after.