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HSG X-Ray
Uterus and Fallopian Tubes
Hysterosalpingography (HSG)
Hysterosalpingography, commonly called HSG, is an important fertility investigation used to examine the uterus and determine whether the fallopian tubes are open. It is an X-ray based procedure in which a special radiographic contrast dye is introduced into the uterus through the vagina and cervix. As the contrast travels through the uterine cavity and fallopian tubes, a series of X-ray images are taken to assess the shape and outline of the uterus and to see whether the tubes allow the dye to pass through normally. HSG is commonly recommended as part of female fertility evaluation because blocked or damaged fallopian tubes can interfere with the normal movement of the egg and sperm. The test may also provide information about certain abnormalities inside the uterine cavity.
A blocked Fallopian tube or a growth in the uterus can significantly reduce chances for pregnancy. If the Fallopian tubes are blocked, the sperm can’t reach the egg to fertilize it.
Watch: HysteroSalpingography (HSG)
A hysterosalpingogram, or HSG is an important test of female fertility potential. The HSG test is an X-Ray test usually done in the radiology department of a hospital or outpatient radiology facility.
- A Radiographic contrast (dye) is injected into the uterine cavity through the vagina and cervix
- First the uterine cavity fills with dye and since the uterus and the fallopian tubes are hooked together, the dye fills the tubes and spills into the abdominal cavity IF the tubes are Open.
Pictures are taken using a steady beam of X-ray 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, or a blockage that would prevent an egg moving through a fallopian tube to the uterus. A blockage also could prevent the sperms from moving into a fallopian tube and fertilizing an egg.
HSG Imaging
What Can HSG Show?
During HSG, contrast dye outlines the uterine cavity and fallopian tubes. X-ray images help doctors assess the uterine cavity and identify possible blockages or abnormalities.
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Tubal Patency Imaging
Contrast Flow Through the Tubes
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HSG Radiographic View
Evaluation of Tubal and Uterine Anatomy
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HSG Report & Imaging
Review of Uterus and Tubal Findings
A hysterosalpingogram is done to
- Find a blocked Fallopian tube. An infection may cause severe scarring of the Fallopian tubes and block the tubes, preventing pregnancy. Occasionally the dye used during a hysterosalpingogram will push through and open a blocked tube.
- Find problems in the uterus, such as an abnormal shape or structure, an injury,polyps,fibroid, adhesion or a foreign object in the uterus. These problems could result in heavy menstrual bleeding and/or repeated miscarriage.
- See whether surgery to reverse a tubal litigation has been successful.
The hysterosalpingogram study takes about 15-20 minutes to perform. The test is usually done in the radiology department of a hospital so there is additional time for the woman to register at the facility and fill out a questionnaire and answer questions regarding allergies to medication etc.
Before the test begins, you will get a painkiller to help you relax and to relax your uterus so it will not cramp during the test.
Details of Procedure as follows
- The patient lies on the table on her back and brings her feet by the side just as in a normal speculum examination or transvaginal ultrasound
- The doctor places a speculum in the vagina and visualizes the cervix.
- Either a soft, thin catheter is placed through the cervical opening into the uterine cavity or an instrument called Allies forceps is placed on the cervix and then a narrow metal cannula is inserted through the cervical opening.
- Contrast is slowly injected through the cannula or catheter into the uterine cavity. An x-ray picture is taken as the uterine cavity is filling and then additional contrast is injected so that the tubes should fill and begin to spill into the abdominal cavity.
- More x-ray pictures are taken as this “fill and spill” occurs.
- The procedure is now complete. The instruments are removed from the cervix and vagina.
- The patient usually remains on the table for a few minutes to recover from any cramping caused by injection of the contrast.
The results of the test can be immediately available. The x-ray pictures can usually be reviewed with the patient several minutes after the procedure is done.
Key questions
Does HSG have any side-effects Or Complications?
Complications commonly associated with a hysterosalpingogram include cramping and spotting.
Rarely HSG may be associated with infections, for which we routinely prescribe prophylactic antibiotics for three days. after the procedure
HSG FAQs
Frequently Asked Questions About HSG
Find answers to common questions about hysterosalpingography, fallopian tube blockage, procedure, timing, results, side effects and fertility evaluation.
The clinic page states that HSG is best performed immediately after menstruation has completely stopped, typically around Day 7 to Day 9 of the cycle. It should not be performed close to ovulation.
Yes. HSG can show abnormalities in the shape or structure of the uterus and may identify findings such as polyps, fibroids, adhesions, septum or other abnormalities within the uterine cavity.
A normal HSG may show a normally shaped uterus, normal-looking fallopian tubes without obvious scarring or damage, and contrast dye flowing through the tubes and spilling normally into the abdominal cavity.
An abnormal result may show that contrast does not pass through one or both fallopian tubes, suggesting possible blockage, scarring or malformation. It may also show uterine abnormalities such as a septum, polyps or fibroids.
HSG can show certain uterine cavity abnormalities, including growths such as fibroids, particularly when they affect the shape or outline of the uterine cavity.
Yes. Polyps inside the uterine cavity may appear as an abnormality on HSG and may require further evaluation depending on the findings.
HSG may show abnormalities caused by adhesions inside the uterus. Further evaluation may be recommended by the fertility specialist depending on the findings.
HSG is primarily used to evaluate the uterus and fallopian tube patency. The source page lists endometriosis among possible causes associated with blocked fallopian tubes, but HSG itself is not a complete diagnostic test for endometriosis.
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