Hysterosalpingogram (HSG): About This Test

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Female reproductive system (front view)

What is it?

A hysterosalpingogram (say "hiss-ter-oh-sal-PING-oh-gram"), or HSG, is an X-ray test. It looks at the inside of the uterus and fallopian tubes. It often is done for women who are having a hard time getting pregnant (are infertile) or who have had repeated miscarriages.

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 connected, 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.

Why is this test done?

An HSG is done to:

  • Check for a blocked fallopian tube.
  • Find problems in the uterus, such as an abnormal shape or structure.
  • Look for an injury, polyps, fibroids, adhesions, or a foreign object in the uterus.

How can you prepare for the test?

  • Before an HSG, tell your doctor if you:
    • Are or might be pregnant.
    • Have had a pelvic infection or a sexually transmitted infection, such as gonorrhea or chlamydia.
    • Are allergic to the iodine dye used or to any other substance that has iodine. Also tell your doctor if you have asthma or are allergic to any medicines. Tell him or her if you have had a serious allergic reaction (anaphylaxis) from any substance. (For example, have you had a reaction to the venom from a bee sting or from eating shellfish?)
  • Your doctor schedules the test to avoid any chance that you might be pregnant. This is soon after your period ends and before your ovary releases an egg (ovulates). It's usually around the middle of your cycle.
  • You may want to bring a sanitary pad to wear after the test. That's because some of the dye may leak from your vagina after the test. You may also have some slight bleeding.

What happens before the test?

  • 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'll be asked to take off your clothes below the waist and drape a gown around your waist.
  • You will need to empty your bladder.

What happens during the test?

  • You will lie on your back on an examination table. You'll raise your feet and put them in stirrups.
  • The doctor uses a device called a speculum to gently spread apart the walls of the vagina. This lets the doctor see the inside of the vagina and cervix. The cervix is washed with a special soap.
  • A thin tube 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. 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 examination table may be tilted or you may be asked to change position.
  • You will most likely feel some cramping like menstrual cramps during the test.
  • After the test, the tube and the speculum are removed.

What are the risks of this 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. Your doctor may give you antibiotics if he or she thinks you might get a pelvic infection.
  • There is a small chance of damaging or puncturing the uterus or fallopian tubes during the test.
  • There is a small chance of an allergic reaction to the iodine X-ray dye.

How long does the test take?

  • The test will take about 15 to 30 minutes.

What happens after the test?

  • You will probably be able to go home right away.
  • You can go back to your usual activities right away.
  • Some of the dye will leak out of your vagina.
  • You may have some vaginal bleeding for several days after the test.

When should you call for help?

Call your doctor or nurse call line now or seek immediate medical care if:

  • You have a fever.
  • You have new or worse pain in your pelvis.

Watch closely for changes in your health, and be sure to contact your doctor or nurse call line if you have any problems.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It's also a good idea to keep a list of the medicines you take. Ask your doctor when you can expect to have your test results.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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