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Hysterosalpingogram (HSG)

What is a hysterosalpingogram (HSG)?

A Hysterosalpingogram, or an HSG for short, is an X-ray test that is done in a radiology practice or department. It involves the injection of a radio-opaque dye into the uterine cavity under pressure and using an X-ray to show where the dye has flowed. 

What is an HSG used for?

An HSG gives really useful information about: 

  • The size and shape of the uterine cavity. 
  • The contour of the walls of the cavity of the womb. 
  • The state of the fallopian tubes. 
  • The presence or otherwise of pelvic adhesions. 

As such, it is a useful part of an initial infertility assessment. 

Do I need an HSG?

Any woman who is seeking medical advice because of delay in conceiving will potentially benefit from an HSG.  An HSG will be particularly useful for women with: 

  • Known uterine fibroids. 
  • A past history of uterine surgery. 
  • Pelvic infection or an undiagnosed menstrual disturbance.  

How will I feel?

There is some local pelvic discomfort associated with HSG’s. This comes in part from manipulation of the cervix and also from the uterus as it is stretched by the distending fluid.

How is an HSG performed?

The cervix is identified in a similar manner to when a pap smear is taken, using a vaginal speculum.  The dye is introduced through the cervix using either a metal tube that screws into the cervix to create a water tight seal or a plastic tube with an inflatable balloon to create a seal. The dye is then steadily injected under increasing pressure until it is seen to spill from the ends of the fallopian tubes into the abdominal cavity. X-rays are taken whilst the dye is being injected. 

The whole procedure generally takes about 30 minutes to perform and afterwards you should feel quite well and normal and may return to work.  If you are in the small group of women who react to the procedure it would be best to rest for the remainder of the day and return to work the following day. 

What are the possible risks of an HSG?

HSG is regarded as a very safe procedure, with less than 5% of patients experiencing any problems other than a temporary discomfort during the procedure. Some patients may have an allergic reaction to the contrast dye. 

The manipulation of the cervix may also cause a reaction that provokes a feeling of dizziness or fainting with associated nausea. This is usually a temporary sensation lasting for up to 1 hour, but it can require treatment. 

The potential risk of infection is reduced to less than 1% by the use of an antibiotic before the procedure but should you develop increasing pelvic pain, a discharge or a fever within 2 weeks of the procedure, it is important to contact the clinic immediately for prompt medical assessment and possible further antibiotic treatment. 

The procedure must be booked for a time in the reproductive cycle when there is absolutely no chance of being pregnant. This is the time from the end of a period until a woman releases an egg cell. For that reason, your HSG must be booked in the first 10 days of your cycle, or even earlier if your menstrual cycle is known to be short. 

How can we help you?

Fertility North will provide you with detailed written instructions about how to book your HSG test at the appropriate time of the cycle.   We will also provide you with medications: 

  • A pain killer – to limit the discomfort that you may feel with the procedure. 
  • An antibiotic – to prevent the procedure introducing bacteria into the womb and causing an infection.  

If you would like more information on the HSG test and whether you may benefit from one, please contact our friendly Administration team.