Hysterosalpingography

Definition

Hysterosalpingography is a special x-ray using dye to look at the womb (uterus) and fallopian tubes.

Alternative Names

HSG; Uterosalpingography; Hysterogram; Uterotubography; Infertility - hysterosalpingography; Blocked fallopian tubes - hysterosalpingography

How the Test is Performed

This test is done in a radiology department. You will lie on a table beneath an x-ray machine. You will place your feet in stirrups, like you do during a pelvic exam. A tool called a speculum is placed into the vagina.

After the cervix is cleaned, the health care provider places a thin tube (catheter) through the cervix. Dye, called contrast, flows through this tube, filling the womb and fallopian tubes. X-rays are taken. The dye makes these areas easier to see on x-rays.

How to Prepare for the Test

Your provider may give you antibiotics to take before and after the test. This helps prevent infections. You may also be given medicines to take the day of the procedure to help you relax.

The best time for this test is in the first half of the menstrual cycle. Doing it at this time enables the health care provider to see uterine cavity and tubes more clearly. It also reduces the risk for infection, and ensures that you are not pregnant.

Tell your provider if you have had an allergic reaction to contrast dye before.

You can eat and drink normally before the test.

How the Test will Feel

You may have some discomfort when the speculum is inserted into the vagina. This is similar to a pelvic exam with a Pap test.

Some women have cramps during or after the test, like those you may get during your period.

You may have some pain if the dye leaks out of the tubes, or if the tubes are blocked.

Why the Test is Performed

This test is done to check for blockages in your fallopian tubes or other problems in the womb and tubes. It is often done as part of an infertility exam. It may also be done after you have your tubes tied to confirm that the tubes are fully blocked after you have had a hysteroscopic tubal occlusion procedure to prevent pregnancy.

Normal Results

A normal result means everything looks normal. There are no defects.

Note: Normal value ranges may vary slightly among different laboratories. Talk to your doctor about the meaning of your specific test results.

What Abnormal Results Mean

Abnormal results may be due to:

• Developmental disorders of the structures of the uterus or fallopian tubes
• Scar tissue (adhesions) in the uterus or tubes
• Blockage of the fallopian tubes
• Presence of foreign bodies
• Tumors or polyps in the uterus

Risks

Risks may include:

• Allergic reaction to the contrast
• Endometrial infection (endometritis)
• Fallopian tube infection (salpingitis)
• Perforation of (poking a hole through) the uterus

Considerations

This test should not be performed if you have pelvic inflammatory disease (PID) or have unexplained vaginal bleeding.

After the test, tell your provider right away if you have any signs or symptoms of infection. These include foul-smelling vaginal discharge, pain, or fever. You may need to take antibiotics if this occurs.

References

Broekmans FJ, Fauser BCJM. Female infertility: evaluation and management. In: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Adult and Pediatric. 7th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 132.

Fettinger S, Fanelli L. Hysterosalpingography and sonohysterography. In: Fowler GC, ed. Pfenninger and Fowler's Procedures for Primary Care. 4th ed. Philadelphia, PA: Elsevier; 2020:chap 134.

Lobo RA. Infertility: etiology, diagnostic evaluation, management, prognosis. In: Gershenson DM, Lentz GM, Valea FA, Lobo RA, eds. Comprehensive Gynecology. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 40.