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A hysterosalpingogram (HSG) is an
X-ray test. It looks at the inside of the
fallopian tubes and the area around them. It often is
done for women who are having a hard time getting pregnant (infertile).
During the test, a dye (contrast material) is put through a thin tube. That tube is put through the vagina and
into the uterus. Because the uterus and the fallopian tubes are hooked
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. They can also show 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. The test also may find problems on the
inside of the uterus that prevent a fertilized egg from attaching (implanting)
to the uterine wall.
A hysterosalpingogram (HSG) is done
Before a hysterosalpingogram (HSG), tell your
doctor if you:
This test should be done 2 to 5 days after your menstrual period has ended. It should also be done before
ovulate the next month (unless you are using
contraception). This is to avoid using X-rays during an early pregnancy. You may want to
bring along a sanitary pad to wear after the test. That's because some leakage of
the X-ray dye may occur along with slight bleeding.
You may be asked to sign a consent form that says you understand the risks of the test and agree to have it done.
Talk to your doctor about any concerns you have about the need for the test, its
risks, how it will be done, or what the results will mean. To help you
understand the importance of this test, fill out the
medical test information form(What is a PDF document?).
A hysterosalpingogram usually is done
radiologist in the X-ray room of a hospital or clinic.
A radiology technologist and a nurse may help the doctor. A
gynecologist or a doctor who specializes in
infertility (reproductive endocrinologist) also may help with the
Before the test begins, you may get a
sedative to help you
relax. You may also get ibuprofen to help relax your uterus so it will not cramp during 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. Then you will lie on your back on an exam
table. Your feet will be raised and supported by stirrups. This allows your doctor
to look at your genital area.
will put a smooth, curved tool called a speculum into your vagina. The speculum gently
spreads apart the vaginal walls. This allows the doctor 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. 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. It will then spill into the belly where it will be
absorbed by the body. If a fallopian tube is blocked, the dye will
not pass through. The X-ray pictures are shown on a TV screen during the test.
If another view is needed, the exam table may be tilted or you may be
asked to change position.
After the test, the cannula or catheter
and the speculum are removed. This test usually takes 15 to 30 minutes.
You will most likely feel some cramping like
menstrual cramps during the test. The amount of pain you have depends on what
problems the doctor finds and treats during the test.
There is always a small chance of damage to
cells or tissue from being exposed to any radiation. This can include the low levels
of radiation used for this test. The chance of damage from the X-rays is
generally very low compared with the possible benefits of the test.
There is a small chance of a pelvic infection after the test.
Examples of these are endometritis and
salpingitis. The chance may be higher
for women who have had pelvic infections before. Your doctor may give you
antibiotics if he or she thinks you might get a
There is a small chance of damaging or
puncturing the uterus or fallopian tubes during the test.
a small chance of an
allergic reaction to the iodine X-ray dye. This is more common
if you are allergic to any shellfish.
In rare cases, if an
oil-based dye is used, the oil can leak into the blood. This can cause blockage
of blood flow to a section of the lung (pulmonary embolism). But in most cases, this test uses water-based dyes.
After the test, some of the dye
will leak out of the vagina. You also may have some vaginal bleeding for
several days after the test. Call your doctor right away if you have:
A hysterosalpingogram (HSG) is an
X-ray test. It looks at the inside of the
fallopian tubes and the area around them.
The shape of the uterus and
fallopian tubes are normal. The fallopian tubes are not scarred or damaged. The
dye flows freely from the uterus and through the fallopian tubes and then spills
normally into the belly.
No objects (such as an
intrauterine device, or IUD), tumors, or growths are
seen in the uterus.
Fallopian tubes may be
scarred, malformed, or blocked so that the dye does not flow through the tubes
and spill into the belly. Blocked fallopian tubes may be caused by
pelvic inflammatory disease (PID) or
The dye may leak through the
wall of the uterus, showing a tear or hole in the uterus.
An abnormal uterus may show
tissue (called a septum) that divides the uterus.
Growths, such as
fibroids, may be present.
You may not be able to
have the test, or the results may not be helpful, if:
This test is not done on women who are having their period,
are pregnant, or have a pelvic infection.
Other Works Consulted
Fischbach FT, Dunning MB III, eds. (2009). Manual of Laboratory and Diagnostic Tests, 8th ed. Philadelphia: Lippincott Williams and Wilkins.
Pagana KD, Pagana TJ (2010). Mosby’s Manual of Diagnostic and Laboratory Tests, 4th ed. St. Louis: Mosby Elsevier.
ByHealthwise StaffPrimary Medical ReviewerSarah Marshall, MD - Family MedicineKathleen Romito, MD - Family MedicineSpecialist Medical ReviewerDeborah A. Penava, BA, MD, FRCSC, MPH - Obstetrics and Gynecology
Current as ofJuly 2, 2015
Current as of:
July 2, 2015
Sarah Marshall, MD - Family Medicine & Kathleen Romito, MD - Family Medicine & Deborah A. Penava, BA, MD, FRCSC, MPH - Obstetrics and Gynecology
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