What is hysterosalpingography (HSG)? | HSG procedure

Hysterosalpingography (HSG) is a type of imaging of a women’s pelvis and reproductive organs. In this procedure, the uterine cavity and fallopian tubes are imaged with the help of a contrast agent and an X-ray called fluoroscopy. A hysterosalpingography is used to examine the structure and function of the uterus and fallopian tubes. This imaging is often recommended to identify and evaluate infertility problems and recurrent miscarriages. An HSG is one of the necessary tests for women before starting infertility treatment.

What are the uses of hysterosalpingography?

The hysterosalpingography allows the specialist to examine the shape and structure of the uterus, the opening of the fallopian tubes, and the presence of any sores or cavities in the uterus. In addition, this photo helps to identify the causes of recurrent miscarriage due to congenital or acquired abnormalities in the uterus. In general, the applications of HSG are:

• Examination of the structure and size of the uterus and fallopian tubes
• Detection of uterine adhesions
• Diagnosis of uterine fibroids
• Diagnosis of polyps or tissue masses in the uterus
• Check the opening of the fallopian tubes
• Examination of tumors and uterine cancer
• The effect of some surgeries, such as opening the fallopian tubes
• Ensuring the outcome of tubal ligation surgery (sterilization)
• Investigate the causes of recurrent miscarriage
• Investigate the causes of IVF failure

The HSG is used only to examine the inside of the uterus and the fallopian tubes. Ovarian problems and other parts of the pelvis can be checked with other methods, such as ultrasound, vaginal ultrasound, or MRI.

How is Hysterosalpingography done?

Taking hysterosalpingography takes an average of 10 to 30 minutes. To do hysterosalpingography, the person lies on a gynecological examination bed. The radiologist holds the cervix open with a speculum. In this case, the iodine-containing contrast agent is injected into the uterus through a thin tube called a cannula. After the uterus and fallopian tubes are filled with contrast material, by irradiating X-rays to the contrast material that is placed in the uterus; Contrast is indicated by white dots on the monitor screen, which indicate the condition of the uterus and fallopian tubes. The radiologist takes several pictures of the uterus and fallopian tubes in different positions and sends them to a specialist doctor. Normally, the contrast agent should evenly fill the uterus and fallopian tubes. If the contrast material does not fill part of the uterus and fallopian tubes, it may indicate an obstruction or some uterine abnormality.

How to get ready for hysterosalpingography?

Before doing hysterosalpingography, if the patient feels anxious, a sedative is prescribed at the doctor’s discretion. In addition, analgesics are recommended to reduce possible pain. Antibiotics are also prescribed before and after an HSG to prevent infection. Since hysterosalpingography can cause harm to the fetus, it is important to make sure that you are not pregnant before doing so.

When is the best time to do the HSG test?

The best time to do an HSG test is one week after your menstruation and before ovulation because there is no chance of pregnancy at this time. In addition, the amount of false abnormalities that occur as a result of increasing the thickness of the uterine wall is less at this time. Because metal parts interfere with the operation of the radiology device, no metal device such as jewelry should be accompanied when doing hysterosalpingography.

Does an HSG hurt?

Uterine contractions during a hysterosalpingography exam, especially when injecting a contrast agent, can cause mild pain.

This pain may be worse if the fallopian tubes are blocked. To reduce the pain, a painkiller is prescribed before doing HSG.

Because hysterosalpingography is associated with more pain and discomfort in some women, and some people are afraid to do it while awake, in some imaging centers, the hysterosalpingography test is performed under anesthesia or light anesthesia. There are benefits to having hysterosalpingography under anesthesia. This reduces pelvic floor muscle contraction and resistance to the imaging device being placed inside the vagina. As a result, the radiologist can perform the necessary procedures for imaging without feeling pain in the patient and ensure the quality of the images.

What are the symptoms after doing an HSG?

People usually do not have any annoying symptoms after doing hysterosalpingography and can resume their normal daily activities. Some of the mild symptoms that can occur after taking a color photo are:

• Cramps in the muscles of the uterus
• Spotting or minor bleeding
• Dilute discharge
• Short-term dizziness, weakness, and nausea
• Feeling of vaginal tightness due to the discharge of contrast material remaining in the uterus
• Feeling of pain during the next menstrual cycle due to cramps in the fallopian tubes

It should be noted that if you notice symptoms such as severe and prolonged abdominal and vaginal pain, unusual bleeding, persistent spotting for more than 24 hours, foul-smelling vaginal discharge, prolonged vomiting, fever, and fainting, you should see a doctor immediately.

What are the benefits of hysterosalpingography?

HSG is one of the methods of imaging the uterus and fallopian tubes that has many advantages. One of the most important advantages of this method is that it does not require surgery and is less invasive. Other benefits of hysterosalpingography include:

• Provides valuable information on the types of infertility disorders and recurrent miscarriage problems. Learn more about infertility problems in women: Female infertility: Symptoms and causes
• It is done in a short time
• Does not cause any side effects
• In cases where the problem of infertility is due to obstruction of the fallopian tubes, injection of a contrast agent can help clear the obstruction of the fallopian tubes and allow the patient to become pregnant.

When should not hysterosalpingography be done?

In some cases, doing a hysterosalpingography exam is not recommended. If any of the following are present or likely to occur, be sure to tell your doctor before doing the HSG test:

• Infection of the uterus and pelvis
• Having sexually transmitted diseases
• History of contrast sensitivity
• Pregnancy or the possibility of pregnancy
• Spasm of the fallopian tubes (can cause a false result)

Does hysterosalpingography (HSG) increase the chance of pregnancy?

If the cause of infertility is obstruction of the fallopian tubes, the obstruction may be removed by injection of a contrast agent. Contrast injections can clear the fallopian tubes by clearing and flushing the fallopian tubes and increasing the chances of an egg reaching the uterus and becoming pregnant. According to scientific studies, the probability of pregnancy up to 3 months after hysterosalpingography (HSG) in people with tubal obstruction increases by about 30%. In addition, hysterosalpingography (HSG) helps to examine uterine problems such as adhesions, lumps, fibroids, tubal obstruction, causes of recurrent miscarriage, etc. by providing clear images of the uterus and fallopian tubes. Therefore, hysterosalpingography (HSG) results can help the specialist in choosing the best method of infertility treatment like IVF and increase the chances of pregnancy.