A hysterosalpingogram, otherwise known as an HSG, is an outpatient procedure that is designed to help determine the shape of the uterus and to find out whether or not the fallopian tubes are open or blocked…
This procedure involves placing an iodine-based dye through the cervix and then taking x-rays. This special kind of x-ray takes only about a half an hour to complete.
When is a Hysterosalpingogram Necessary?
Depending on a woman’s infertility history, an HSG may be ordered as part of a typical infertility work-up. This procedure is usually suggested if a woman has been through at least two miscarriages, because an abnormal uterine shape can cause repeated pregnancy loss. In fact, for approximately 15% of women experiencing recurrent pregnancy loss, an unusually shaped uterus is a major factor. An HSG can also determine whether or not the fallopian tubes are blocked or open. If the fallopian tubes are obstructed, the egg cannot meet the sperm and thus a woman will not be able to get pregnant.
Typically, an HSG is done before ovulation (between day 10 and 12 of the menstrual cycle), so that it won’t interfere with a pregnancy. If this procedure is recommended by your reproductive specialist, you will work closely with staff at the fertility clinic to correctly schedule it as coordinating the right day can sometimes be difficult, especially if you have irregular periods.
What to Expect During an HSG Procedure
The HSG is an in-and-out procedure and does not require general anesthesia, so no fasting is involved. Some fertility doctors may recommend taking an over-the-counter pain medication like ibuprofen, or even a prescription medication to reduce anxiety, about an hour before the procedure is scheduled. While there is minimal pain involved, these medicines can help in case there is some minor discomfort.
Are There Any Risks Involved with an HSG?
Overall, an HSG is considered to be a safe procedure, although there are a few potential risks. On rare occasions, infection may occur. Some doctors prefer to prescribe antibiotics to guard against potential infection. (If you have a fever or feel increasing pain after the test, be sure to contact your doctor right away). Other potential issues that could occur include fainting during or after the test and/or experiencing an allergic reaction to iodine, which is quite rare. It is important to tell your doctor prior to the test if you are allergic to iodine or shellfish. Also let your doctor know if you have any itching or swelling after the test.
An HSG is an x-ray and therefore it involves a very low amount of radiation. While the low amount does not seem to cause any unwanted side effects, it should not be done during pregnancy.
How to Interpret the Results of an HSG
The test results are considered normal when the x-ray shows a normal shaped uterus and the injected dye flows freely out at the ends of the fallopian tubes. If this is the case, abnormal uterine shape or tubal factor infertility is most likely not the cause of infertility.
On the other hand, if the dye shows an abnormally shaped uterus, or if the dye does not flow freely from the fallopian tubes, there may be a problem. Approximately 15% of women have a “false positive” however, where the dye somehow does not get past the uterus and into the tubes. On the x-ray, the blockage will seem to be where the fallopian tube and uterus meet. When this happens, the fertility doctor may decide to repeat the test at another time; sometimes, however, the doctor may decide to order a different test to confirm.
While an HSG can indicate that the fallopian tubes are blocked, this test cannot explain why the dye will not flow freely through the tubes. When necessary, your fertility doctor may want to schedule additional testing, such as an exploratory laparoscopy or a hysteroscopy. This further testing will allow the doctor to investigate and possibly correct any issues.
Take control of your infertility and make an appointment today with one of our compassionate and highly trained fertility specialists. The Center of Reproductive Medicine (CORM) serves the greater southeast area of Texas with full-service fertility clinics in Houston, Webster, and Beaumont. The professional staff at CORM uses the latest techniques and procedures to help patients achieve the gift of a new life. The physicians and experienced staff at the Center of Reproductive Medicine will work closely with you to choose the most appropriate fertility program for your individual reproductive medical needs.
