A hysterosalpingogram (HSG) is an X-ray test that looks at the inside of the uterus and Fallopian tubes and the area around them. The procedure often is done for women who are having problems becoming pregnant (infertile).
During a HSG, a dye (contrast media) is put through a thin tube that is put through the vagina and into the uterus. Because the uterus and the Fallopian tubes are connected together, the dye will flow into the Fallopian tubes. Pictures are taken using a steady beam of X-ray (fluoroscopy) as the dye passes through the uterus and Fallopian tubes.
The pictures can show problems such as an injury or abnormal structure of the uterus or Fallopian tubes, or a blockage that would prevent an egg moving through a Fallopian tube to the uterus. A blockage also could prevent sperm from moving into a Fallopian tube and joining (fertilizing) an egg.
A hysterosalpingogram also may find problems on the inside of the uterus that prevent a fertilized egg from attaching (implanting) to the uterine wall.
Why It Is Done
A hysterosalpingogram is done to:
• Find a blocked Fallopian tube. The test often is done for a woman who is having a hard time becoming pregnant. An infection may cause severe scarring of the Fallopian tubes and block the tubes, preventing pregnancy. Occasionally the dye used during a hysterosalpingogram will push through and open a blocked tube.
• Find problems in the uterus, such as an abnormal shape or structure, an injury, fibroids, polyps, adhesions or a foreign object in the uterus. These types of problems may cause painful menstrual periods or repeated miscarriages.
• See whether surgery to reverse a tubal ligation has been successful.
How To Prepare
This test should be done 2 to 5 days after your menstrual period has ended to be sure you are not pregnant. It should also be done before you ovulate the next month (unless you are using contraception) to avoid using X-rays during an early pregnancy. You may want to bring along a sanitary napkin to wear after the test because some leakage of the X-ray dye may occur along with slight bleeding.
How It Is Done
- A hysterosalpingogram usually is done by a Radiologist in the fluoroscopy X-ray room at Imaging and Ultrasound Inc. A radiographer and a nurse may help the doctor. A referring physician or gynecologist or a doctor who specializes in infertility may also perform the test.
- You will need to take off your clothes below the waist and drape a gown around your waist.
- You will empty your bladder and then lie on your back on an examination table with your feet raised. This allows your doctor to look at your genital area.
- Your doctor will put a smooth, curved speculum into your vagina. (the same as having a PAP smear) The speculum gently spreads apart the vaginal walls, allowing him or her to see the inside of the vagina and the cervix.
- The cervix may be held in place with a clamp called a tenaculum. The cervix is washed with a special soap and a stiff tube (cannula) or a flexible tube (catheter) is put through the cervix into the uterus. The X-ray dye is put through the tube. If the Fallopian tubes are open, the dye will flow through them and spill into the belly where it will be absorbed naturally by the body. If a Fallopian tube is blocked, the dye will not pass through. The X-ray pictures are shown on a TV monitor during the test and recorded digitally.
- After the test, the cannula or catheter and speculum are removed. This test usually takes 15 to 30 minutes. You should wear a sanitary pad for the next few hours as the contrast media may still leak out and is slightly sticky. You may also experience slight spotting (bleeding) from the introduction of the instruments.
- You will be given a CD with the images on and the report will be faxed to your referring physician.