Hysterosalpingogram: Purpose, Procedure & Risks

A correct infertility diagnosis is important for anyone who is struggling with fertility issues. Getting to the root cause of your problems is the first step in the journey towards bringing home a baby. Every patient arrives at the fertility clinic with their own history and unique needs, but a vast majority of infertility cases are caused by a handful of common problems.

What is a Hysterosalpingogram?

HSG is a special type of X-ray examination of the fallopian tubes and uterus to see if the fallopian tubes are patent (open) and if the inside of the uterus(uterine cavity) is normal.

Tubal Factor Infertility

Tubal factor infertility, a problem with women’s fallopian tubes, is one of the most common causes (Between 25 to 30 percent of female infertility is caused by the tubal factor). If your tubes are blocked the sperm will not reach the egg hence fertilization/ pregnancy will not occur. In case your doctor suspects that a blockage in your fallopian tubes could be a factor in your case, they may recommend that you undergo a test called hysterosalpingogram or HSG.

An HSG test is also sometimes used for women who have suffered from repeated pregnancy losses.

When and where HSG Test is done?

HSG is an OPD procedure done usually between days 5 to 10 of your menstrual cycle, once you have stopped bleeding. It is done at a radiology center.

How long the HSG Test will take?

It takes just about 5-10 minutes and you can go back home after half an hour.

Hysterosalpingogram Procedure

A woman is positioned under a fluoroscope(X-ray imager) on an examination table, the gynecologist or radiologist examines the patient and places a speculum in her vagina, her cervix is cleaned and a cannula placed in the opening of the cervix. The doctor gently pushes a contrast dye into the uterus and two or three X-ray images are taken. The contrast will show the contour of the uterus and outline the length of the tubes and spill out of the ends if the tubes are open.

hysterosalpingogram procedure

HSG is a safe procedure but some women may experience a fainting episode or an allergic reaction to the contrast dye. Please inform the doctor beforehand if you have any allergies.                                           

Does a Hysterosalpingogram hurt?

The truthful answer would be it depends… Some women report mild to moderate cramping, some don’t feel much, and very few report severe cramping.

Retrospectively some may say that their fear of pain was much worse than the discomfort they felt. But you are given painkiller tablets or injections as premedication to minimize the discomfort.

Does HSG enhance fertility?

It is controversial whether this procedure enhances fertility. Some studies show a slight increase in fertility lasting about three months after a normal HSG. However, most doctors perform HSG only for diagnostic reasons.

The radiologist will give your reports and films on the same day and you can contact your gynecologist to discuss the reports.

A few images of what HSG reports look like.

Normal Tubesnormal tubes
Blocked Tubes

blocked tubes



What after HSG Test?

You may experience some mild cramping and have spotting for a couple of days and there can also be leakage of the contrast dye, so bring a pad along. Wearing a pad for the rest of the day will help protect your clothing.

Most patients are able to drive themselves home after an HSG but if you are not feeling well you might prefer having someone to drive you home.

You will be given antibiotics and painkillers for the next few days after HSG.

After HSG you should recover very quickly and be back to normal activities by the next day. Heavy bleeding, severe pain, foul discharge or fever are not normal side effects and should be investigated immediately.                                      

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