Hysterosalpingogram or HSG: Your Questions Answered!

Your questions answered about… hysterosalpingograms (HSG)!

What is it?

• Hysterosalpingogram, or HSG, is a radiology study of a woman’s reproductive system, specifically the uterus and fallopian tubes.
• Images are taken with low dose x-rays and fluoroscopy.

Why do we do it?

• The examination is often ordered to see whether the uterine tubes are blocked for the following reasons:
  • difficulty getting pregnant
  • prior fallopian tube surgery
  • prior pelvic infections
  • HSGs can evaluate developmental or congenital deformity of the shape of the uterus.
• Some sterilization procedures (like Essure tubes) require an HSG to show the tubes are blocked.

How do we do it?

• The procedure typically lasts about 15 minutes, not counting the setup time.
• The procedure requires an injection of iodinated contrast material (a form of dye specifically used with x-rays). This colorless liquid is injected through a small catheter that is placed in the patient’s uterus through the cervix.  X-ray images are taken of the pelvic region while the contrast fills the uterus and hopefully the fallopian tubes. Cramping occurs when the uterus is filled, but most patients tell us the anticipation is worse than the experience!
• Often times, the radiologist can show you your images right after the test, providing immediate results.

Do I need to do anything to prepare for the test?

• You will be asked to schedule your appointment between days 7 through 11 of your menstrual cycle. Day 1 of your menstrual cycle is the day you start your period and the exam is done 7 – 11 days following when you are no longer bleeding.
• The test should be done after normal menstruation – this is to make sure you are not pregnant when we do the procedure.
• The day of your exam we recommend taking ibuprofen (600 mg) by mouth 1 hour prior to your scheduled exam time as this will really help to limit cramping that can result from the procedure.
• We will ask for a list of your medications and drug allergies. If you have had a prior reaction to a contrast material, we will discuss the reaction with you and may adjust how we do the procedure.

Are there risks?

• One of the main risks of the procedure is infection. The procedure is done with sterile technique to prevent infection. In some cases depending on the results of the study, oral antibiotics may be prescribed.

Anything to know after the procedure?

• After your HSG is completed, you may experience mild cramping. There may be a small amount of vaginal spotting which should not be heavy or last longer than a couple of days. Most women return to normal activity that day without limitation.
• Results will be interpreted by the radiologist and a final report will be sent to your provider.

We hope this description helps relieve some anxiety! This is definitely a stressful test, and reading online accounts may increase that anxiety. Rest assured, we will do all we can to make the procedure as stress-free as possible.