Hysterosalpingogram (HSG)

What is a hysterosalpingogram?

A hysterosalpingogram (HSG) is a minimally invasive test that can provide valuable insight into female infertility. This is typically performed to diagnose issues and determine an effective treatment plan for individuals struggling with infertility. For most patients, HSG is similar to a yearly gynecological examination and involves minimal discomfort. 

When to undergo an HSG

For women who struggle to conceive or have experienced pregnancy losses, your doctor may order an HSG to diagnose the causes of infertility. Uterine abnormalities that can be diagnosed with an HSG include: 

• Uterine scar tissue
• Uterine fibroids
• Uterine tumors or polyps
• Uterine structural anomalies
• A fallopian tube blockage

The HSG procedure

Undergoing an HSG is very similar to your standard pelvic exam. On the day of the procedure, the physician will insert a speculum into the vaginal canal. The cervix is then cleaned, and the patient may receive a local anesthetic at the cervix to minimize discomfort.

Then, a long, thin medical instrument called a cannula is inserted into the cervix and the speculum is removed. Dye is injected via the cannula, into the uterus and fallopian tubes. Patients may experience minor cramping or pain as the dye moves into the fallopian tubes. The patient will then be placed under an X-Ray machine to take images at a variety of angles. 

When the X-Rays are complete, the radiologist will remove the cannula. 

After your HSG

Patients may experience cramps and abdominal discomfort similar to a menstrual cycle following an HSG. Vaginal discharge or minor vaginal bleeding are other common side effects.

Following an HSG, patients should use a sanitary pad rather a tampon to control bleeding. The patient may also report feeling dizzy or nauseous. These normal side effects quickly resolve, and are no cause for alarm. 

However, be on the lookout for infection and notify your doctor if you experience:

• Severe pain and cramping
• Foul-smelling vaginal discharge
• Heavy vaginal bleeding
• Fever
• Vomiting
• Fainting

Once your doctor has received and reviewed the results, you may need additional testing or you may create a fertility treatment plan.