Hysterosalpingogram (HSG): Understanding the Procedure

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A Hysterosalpingogram (HSG) is a specialized X-ray procedure used to evaluate the uterus and fallopian tubes, helping doctors understand potential causes of infertility or recurrent miscarriages. The test can show if the fallopian tubes are open and if the shape of the uterus is normal. Understanding the process and what to expect can help you feel more at ease.

An HSG is a minimally invasive procedure where a special dye (contrast material) is injected into the uterus and fallopian tubes. X-ray images are then taken to track how the dye flows, which helps doctors see the inner structure of your reproductive organs.

HSG is commonly performed to:

• Evaluate fertility: Check for blocked fallopian tubes and assess the shape of the uterus.
• Assess the uterus: Abnormalities like fibroids, polyps, or congenital issues can affect fertility or lead to miscarriages.
• Post-surgery check: Confirm the success of surgeries like tubal ligation reversal or corrections of uterine abnormalities.
• Assess post-infection damage: Determine if infections like pelvic inflammatory disease (PID) have caused damage to the fallopian tubes.

Typically, an HSG is done between days 6 and 12 of your menstrual cycle. Here’s how to prepare:

• Pain relievers: Your doctor may recommend taking ibuprofen before the procedure to help reduce discomfort.
• Antibiotics: In some cases, antibiotics are prescribed to prevent infection.
• Empty your bladder: You will be asked to do this before the test.
• Allergies: Let your doctor know if you have any allergies to contrast dyes.

It’s also a good idea to bring a sanitary pad for afterward, as some dye may leak.

Here’s a step-by-step overview of what to expect during the procedure:

1. Positioning: You’ll lie on an X-ray table, similar to a pelvic exam, with your legs in stirrups.
2. Speculum insertion: A speculum is inserted to gently open your vagina so your doctor can see the cervix.
3. Catheter insertion: A thin tube (catheter) is inserted through your cervix and into your uterus, and contrast dye is introduced.
4. X-ray imaging: As the dye flows through your uterus and fallopian tubes, X-ray images are taken. This shows if the tubes are open and whether there are any abnormalities in the uterus.
5. Completion: Once enough images are taken, the speculum and catheter are removed.

The entire procedure usually takes about 5 minutes.

Most women experience mild cramping during the procedure, similar to menstrual cramps. This usually occurs when the dye is injected, and the sensation subsides shortly after.

You can return to normal activities immediately after your HSG. Some common side effects may include:

• Mild cramping or bloating.
• Light spotting or vaginal discharge.

Rarely, complications such as infection or allergic reactions to the dye may occur. Contact our office if you experience heavy bleeding, severe pain, fever, or unusual discharge.

Dr. Silberzweig will review the results with you on the same day. Possible outcomes include:

• Normal results: If your tubes are open and your uterus appears normal, your doctor may explore other causes of infertility.
• Abnormal results: If blockages or abnormalities are found, your doctor may recommend further treatments such as surgery or assisted reproductive technologies like IVF.

Interestingly, some women become pregnant naturally after an HSG, especially if the procedure clears minor blockages in the tubes.

HSG is a valuable diagnostic tool that provides important insights into the health of your reproductive organs. While it may cause temporary discomfort, the procedure offers crucial information that can guide your fertility treatment. If you have any questions or concerns, don't hesitate to discuss them with our staff at Interventional Radiology.