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Hysterosalpingogram (HSG)
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A HSG, short for "hysterosalpingogram", is an x-ray test that looks within the fallopian tubes and the uterus, and checks for: |
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 Problems such as an injury or abnormal structure of the uterus or fallopian tubes
Ablockage that would prevent an egg moving through a fallopian tube to the uterus
An HSG is a simple outpatient procedure and takes less than 30 minutes. This test is usually done 2 to 5 days after menses (to be sure that you are not pregnant) and before ovulation (to avoid using X-rays during an early pregnancy). Slight bleeding and leakage of the X-ray dye (contrast) might occur in some cases, and it is recommended that you bring along a sanitary napkin to wear after the test. |
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Procedure |
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You will need to empty your bladder and lie on your back on an examination table with your feet raised and supported by stirrups (You will need to take off your clothes below the waist and drape a gown around your waist). This is necessary for the doctor to examine your genital area.
You will be positioned under a fluoroscope(a real-time x-ray imager). The gynecologist or radiologist examines your uterus and places a speculum in the vagina. The cervix is washed with a special soap, and a stiff tubular device (cannula) is put through the cervix into the uterus. The physician then gently fills the uterus with a liquid containing iodine (contrast) through the cannula. If the fallopian tubes are open, the contrast will flow through them and spill out at their ends, where it is naturally absorbed by the body. Any abnormalities in the uterine cavity or fallopian tubes will be visible on a TV monitor. The examination table may be tilted or you may be asked to change position if sideviews are needed. You can immediately resume normal activities after the HSG, although you might be asked to desist from intercourse for a few days after the test. The HSG is not designed to evaluate the ovaries or diagnose endometriosis. |
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How uncomfortable does it get? |
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An HSG usually causes mild or moderate uterine cramping for five minutes to even several hours. However, related medications significantly reduce menstrual cramps. |
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Does a hysterosalpingogram enhance fertility? |
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Although some studies indicate a slight increase in fertility lasting about three months after a normal HSG, it is still a matter of debate. HSG is performed only for diagnostic purposes by most physicians. |
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Complications |
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The HSG is accepted as a very safe procedure. However, there is a less than 1% chance of any of a set of recognized complications arising, of which a few can be serious: |
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Infection: A pelvic infection ranks as the most common serious problem with HSG. The probability is higher for those who have |
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had a pelvic infection or tubal disease before. In rare cases, the infection can damage the fallopian tubes or even necessitate their removal. It is recommended that you call your doctor if you experience increasing pain or a fever within one to two days of the HSG. |
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Radiation Exposure: The chance of damage to cells or tissues from being exposed to radiation from the X-rays is very low, less |
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than a kidney or bowel study. There have been no demonstrated ill effects from this radiation, even if conception occurs later the same month. HSG should be avoided if pregnancy is suspected. |
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Iodine Allergy: There is a very rare chance of an allergic reaction to the iodine contrast used in an HSG. Inform your doctor if you |
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are allergic to iodine, intravenous contrast dyes, or seafood (shellfish in particular). Contact your doctor if you develop a rash, itching, or swelling after the HSG. A Sonohysterogram (which uses non-iodine containing fluids) can performed as an alternative to HSG for patients allergic to iodine. Though Sonohysterograms provide good detail about the uterine cavity, they give only limited information about the fallopian tubes |
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Spotting: Spotting commonly occurs for one to two days after the HSG. Call your doctor if you experience heavy bleeding after HSG. |
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Fainting: In rare cases, patients might get light-headed during or soon after the procedure. |
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