Posted October 1, 2022 by Anusha ‐ 4 min read
A hysterosalpingogram is an X-ray dye test that allows your provider to see your uterus and fallopian tubes. It can help your provider diagnose fertility problems arising from having blocked fallopian tubes.
What is Hysterosalpingogram?
A hysterosalpingogram (HSG) is an X-ray dye test used to diagnose problems related to fertility.
During an HSG, an X-ray records images of your uterine cavity and fallopian tubes while they’re filled with a special dye.
An HSG can help your provider spot issues in your reproductive anatomy that may prevent you from getting pregnant.
These issues include blocked fallopian tubes and an irregularly shaped uterus.
Uses of Hysterosalpingogram
An HSG can help your provider see if your fallopian tubes are open or blocked.
This information can help your provider diagnose fertility problems.
Open fallopian tubes allow a clear path for conception to occur.
Sperm travel through fallopian tubes to fertilize an egg.
The fertilized egg (embryo) travels through your fallopian tubes to your uterus (womb), where it can grow and develop into a healthy fetus.
Blocked fallopian tubes prevent these processes from happening and are a leading cause of infertility.
An HSG can also allow your provider to:
Check the success of a tubal ligation or tubal reversal - An HSG can show whether a tubal ligation procedure successfully closed your fallopian tubes so that you can’t get pregnant. It can also show if the procedure was successfully reversed.
Plan for further imaging - An HSG can show irregularities in your uterus (fibroids, abnormal shape) that your provider can use to plan for further imaging, including sonohysterography and hysteroscopy. A sonohysterography can further define the results of an HSG and provide a final diagnosis, while hysteroscopy can treat specific conditions involving your uterus.
How to prepare for a Hysterosalpingogram?
Follow your provider’s instructions to prepare for your procedure. Your provider may recommend that you:
Take over-the-counter medicine for pain an hour before your procedure.
Take antibiotics beforehand to prevent infection.
Arrange for someone to drive you home after your HSG. You may feel up to driving yourself, or you may experience cramping that makes driving difficult. It’s a good idea to have someone to assist, just in case.
What to expect during a Hysterosalpingogram?
An HSG takes less than five minutes. You’ll be able to go home the same day of your procedure.
During the procedure, your provider will inject a solution with dye into your uterus and fallopian tubes while an X-ray records images.
Preparing for the dye injection
You’ll lie on a table, with your knees bent and legs open, as if you were having a pelvic exam. The machine taking the x-ray (fluoroscopy machine) will be positioned above the table.
Your provider will insert a tool called a speculum into your vagina that will widen it, allowing your provider to access your cervix.
Your provider will clean your cervix and insert a small catheter in the cervical canal and into your uterus.
The catheter may be a thin plastic tube called a cannula.
Or, your provider may use a thin plastic tube with a balloon at the end.
The balloon inflates once it’s inside your body to hold the tube in place for the dye injection.
Injecting the dye
Your provider will remove the speculum, and you will then be asked to straighten your legs flat on the table.
Your provider will slowly pump the dye solution into your uterus while the radiology technician operates the fluoroscopy machine over your pelvic area.
You may feel cramping at this point.
If your fallopian tubes are blocked, they may slightly stretch from the pressure.
Your provider may place you in different positions to assess how the solution moves through your fallopian tubes.
If your fallopian tubes are open, the dye should spill out and be seen to spread close to your bowel (it will then get absorbed by your body without consequences).
If they are blocked, the dye won’t spill out.
Risks of Hysterosalpingogram
An HSG uses radiation to record X-ray pictures, but the amount of radiation is minimal. An HSG isn’t considered risky. Rare complications may include:
Injury to your uterus.
An allergic reaction to the dye solution.
What do the results mean?
Your provider will tell you your results and advise you on next steps.
If the HSG shows blockage, your provider may recommend additional procedures like a laparoscopy to further diagnose and treat the problem.
Or, they may recommend fertility treatments that don’t require your fallopian tubes to be clear, like in vitro fertilization (IVF).