Hysterosalpingography (HSG) is a special procedure that uses X-rays and a dye to visualize the inside of the uterus (womb) and the fallopian tubes. This is often done for patients who are trying to conceive to determine whether the tubes are completely or partially blocked and the cavity of the uterus has a normal size or shape. Patients who have undergone tubal sterilization can also do HSG to ensure that the tubes were properly tired.
Who cannot do HSG?
You cannot do the procedure if you are 1. Pregnant 2. Bleeding 3. Pelvic infection. If you have infection, your doctor will give you treatment and the procedure will be rescheduled after the treatment.
Why it’s done
HSG is done for women with infertility problems to determine the patency of the fallopian tubes and the uterine cavity (inside the womb). It can be done to check the quality of the uterine scar after uterine surgeries. Patency of the fallopian tubes can also be checked after tying the fallopian tubes as a form of permanent family planning.
HSG uses X-Rays and a dye. Some people may be allergic to the dye been used. Unfortunately, the doctor performing the procedure cannot determine which patient may be allergic to the procedure. Kindly inform the doctor if you have any allergies. The X-rays may have effect on a fetus if you do the procedure while pregnant. If you are not sure whether there is pregnancy or not, you will have to do a pregnancy test, the morning of your test. If pregnancy is confirmed, the procedure is cancelled. The test may cause a miscarriage if you are pregnant. You may also experience heavy vaginal bleeding, offensive vagina discharge, severe abdominal cramps. Call your doctor if you experience any of these symptoms.
How you prepare
The test is done between 5-10 days of your cycle (1-5 days after your menstrual period). Before you take the HSG test, the doctor may inject a sedative (to calm you down and take away the pain), for this reason, you do not need to eat before the procedure; however some doctors do not give this injection and you can have your normal meals and continue to take your usual medications. Some doctors may give you pain reliever an hour before the test and antibiotics a day before and after the procedure. This is not routine. You will be asked to change into a gown and to remove your underwear.
What can I expect during my HSG test?
1. You will be asked to lie on your back with your feet placed to expose your pelvic region. The vulva is cleaned to prevent infection.
2. A device called a speculum is inserted into the vagina to allow the cervix to be seen. The cervix is cleaned.
3. The end of the cervix may be injected with local anesthesia (pain relief). Alternatively, you may be injected with a sedative.
4. The cervix is grasped with a device to hold it steady. A cervical cannula is then inserted into the cervix. The dye is injected to visualize the uterine cavity and the fallopian tubes.
5. Xrays are taking while the dye is injected. You may be asked to change position for better visualization of the tubes.
6. The dye may cause cramping. If the tubes are blocked, the fluid will cause them to stretch and cause pain if anesthesia was not giving initially.
7. If there is no blockage, the fluid will spill slowly out the far ends of the tubes. After it spills out, the fluid is absorbed by the body.
What should I expect after the test?
After HSG, you can expect to have a sticky vaginal discharge as some of the fluid drains out of the uterus. The fluid may have a tinge of blood. A pad can be used for the vaginal discharge. Do not use a tampon. You may also experience slight vaginal bleeding, abdominal cramps, feeling dizzy or faint especially if you were giving a sedative.
Someone may have to drive you home after the procedure if you were giving a sedative, so speak to your health care provider prior to the test.
A doctor specially trained to interpret HSG (radiologist) will analyze the images from your test and report the findings to your doctor. Your doctor will discuss the details of the report with you and the next steps. The results may show
- Both fallopian tubes are opened and normal. The uterus is normal
- One of the fallopian tubes is blocked.
- The uterus is enlarged and pelvic ultrasound scan may be recommended for further assessment.