HSG

Blocked fallopian tubes can make it difficult for a woman to get pregnant. In case of blockage of the fallopian tubes, sperms are unable to reach the egg to fertilize. These tubes can be blocked for a number of reasons, including chronic history of pelvic inflammatory disease. To diagnose the patency of the fallopian tubes, healthcare providers perform an investigation known as the hysterosalpingography (HSG) test.

An HSG test used in combination with a contrast dye that helps diagnose the patency of the fallopian tubes. During the procedure an x-ray is used to record the anatomy of the uterus and fallopian tubes after they are filled with a special contrast solution. With the help of this x-ray image, points of blockage in the reproductive anatomy can be outlined. Commonly diagnosed conditions with an HSG test include irregularly shaped uterus and blocked fallopian tubes.

When is an HSG test performed?

The right time for getting a hysterosalpingogram is during the first two weeks of the menstrual cycle, the time before ovulation, after the menstrual cycle has ended.

It may be prescribed by the healthcare provider if:

• They want to check the patency of the fallopian tubes following a history of infertility. As mentioned before, if the fallopian tubes are blocked or scarred, the sperm is unable to fertilize the egg for pregnancy.
• Some healthcare providers perform this investigation to check the success of tubal reversal or tubal ligation. Whether or not either procedure is successful or not can be checked through this investigation. Tubal ligation is done for prevention of pregnancy, while tubal reversal is done to open the ligated tubes.
• A hysterosalpingogram can check for irregularities in the uterus and plan for further imaging like hysteroscopy and sonohysterography.

When shouldn’t an HSG test be performed?

The two conditions during which hysterosalpingogram should not be performed include:

• Pregnancy
• Active pelvic inflammatory disease (PID) or pelvic infection

Who performs an HSG test?

This test is performed by a reproductive endocrinologist, radiologist or the OB-GYN. The results are then interpreted by a radiologist.

HSG test procedure

During this test, a dye is filled into the uterus that flows through the fallopian tubes and outlines them. If the fallopian tubes are open, the dye can easily flow through; in case of blockage the dye will have a barrier to its flow.

What are the risks of an HSG Test?

The dangers of the procedure are minimal with hysterosalpingogram, but as with any procedure, there are certain risks. The risk that warrant examination by the healthcare provider include:

• Unpleasant vaginal discharge as the dye leaves the uterus.
• Vomiting
• Severe pain
• Fainting
• Heavy vaginal bleeding
• Fever
• Allergic reaction
• Injury to the uterus
• Pelvic infection

There is minimal risk of the procedure, and it is even safe to try to get pregnant in the days following hysterosalpingogram. If, however, your healthcare provider advises otherwise, then it is better to refrain.

What are the side effects of an HSG Test?

The most common side effects of hysterosalpingogram is cramping abdominal pain. This discomfort can be eased with the use of over-the-counter pain medication like acetaminophen for a few days following the procedure until the symptoms ease. A pad can be used for the vaginal discharge but a tampon must not be used.

What do the results mean?

Following the investigation, the results are interpreted and explained by your healthcare provider. In case the hysterosalpingogram shows blockage of the fallopian tubes, further investigations including laparoscopy to make a definitive diagnosis may be needed. Alternates for blocked fallopian tubes for pregnancy include in vitro fertilization (IVF).

Can a hysterosalpingogram improve the chances of fertility?

Sometimes the process of injecting dye in the uterus and the fallopian tubes helps flush out the fallopian tubes and therefore improves the fertility in the following three to six months duration. With oil-based contrast medium in particular, the contrast rate is even higher. The idea behind this is that the dye solution can help to clear minor blockages in the fallopian tubes.