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Hysterosalpingography

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

Alternative Names

HSG; Uterosalpingography; Hysterogram; Uterotubography

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 doctor 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 about 7 or 8 days after the bleeding from your menstrual period has stopped. Doing it at this time also reduces the risk for infection, and ensures that you are not pregnant.

Tell your doctor or nurse 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 smear. 

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


  • 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 health care provider right away if you have any signs or symptoms of infection. These include foul-smelling vaginal discharge , pain, or fever.

References

Lobo RA. Infertility. In: Lentz GM, Lobo RA, Gershenson DM, Katz VL, eds. Comprehensive Gynecology. 6th ed. Philadelphia, PA: Mosby Elsevier; 2012:chap 41.

Updated: 3/11/2014

Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.


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