Hysterosalpingography (HSG)

-This is how it works-

During a fertility evaluation you sometimes need to find out if there is a free passage through the fallopian tubes. Can the egg reach the uterus? Is there anything that prevents the egg from attaching there? This is how it works!

To see if there is a free passage through the fallopian tubes, in other words, if the fallopian tubes block the egg from reaching the uterus, you may need a special type of ultrasound examination. This examination also aims to find out if there are any malformations in the uterine wall that could pose a barrier for a fertilized egg to attach there. This exam is called Hysterosalpingography, HSG or “tubogram”.

Why is a hysterosalpingography (HSG) done?

An HSG is normally performed if you have not found any explanation for infertility in the earlier steps of the fertility evaluation and / or if you consider, for example, fertility treatments other than IVF. Some IVF clinics will always do an HSG.

How it works
  • The procedure should be carried out during the first half of your cycle, usually on day 5-10 of your cycle (day one of your cycle is the first day of your period).
  • X-rays are included in the examination. A thin tube called a cannula will be inserted into your cervix through your vagina. Your uterus will then gently be filled with a contrast liquid containing iodine. The iodine contrasts with your uterus and fallopian tubes on the X-rays. The contrasting liquid will show the outline of your uterus and fallopian tubes and how the fluid moves through them. There is also another method that uses saline and air instead of dye and an ultrasound.
Does a hysterosalpingography (HSG) hurt?

The experience differs from woman to woman but the majority say that it is like a combination of an ultrasound and a gynecological pap test (pap smear). You can thus mentally prepare yourself for whether you will feel pain or not by considering your perceived pain (if you have had any) during a gynecological pap test. You might experience cramps during the procedure.

Possible discomforts after the procedure
  • Possible discomforts after the procedure include vaginal spotting, cramps, dizziness and stomach ache. It is important that you call your doctor if you experience any of the following symptoms:
  • Vaginal discharge that smells unpleasant
  • Heavy vaginal bleeding
  • Severe pain or cramping in your abdomen
  • Vomiting
  • Fainting
  • Fever
The results

A radiologist will look at the X-ray images and notify your doctor about the results. Your doctor will then consult you and explain if more tests are needed, such as a laparoscopy.

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Hysterosalpingography (HSG) – This is how it works!
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