ysterosalpingography (HSG) is a procedure used to diagnose certain problems of the uterus and fallopian tubes. HSG most often is used to see if a woman's tubes are partly or fully blocked. Blocked tubes are a common cause of infertility. HSG also is used to help find the cause of repeated pregnancy loss.
This pamphlet will explain:
- Why HSG may be done
- How it is done
- What to expect before and after HSG
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| HSG is a way to diagnose problems of the uterus and fallopian tubes. |
Why Is HSG Done?
With HSG, the doctor can check for blockage or growths inside the uterus and tubes. This may help your doctor find the cause of infertility or repeated pregnancy loss (also called repeated miscarriage).
Blockage of one or both fallopian tubes causes about 35% of cases of infertility in women. Partial or complete blockage of a tube can prevent a fertilized egg from moving into the uterus. Tubal blockage may result from scarring from a past infection, endometriosis, or surgery.
HSG also is done to detect growths or scarring inside the uterus or problems in its size or shape. This can be the cause of repeated pregnancy loss.
What to Expect
HSG will be done in a special X-ray area in the hospital, clinic, or doctor's office. It is best to have HSG during the first half (days 1–14) of a woman's menstrual cycle. This timing reduces the chance that a woman may be pregnant during the procedure.
HSG is not done in a woman who:
- Is pregnant
- Has a pelvic infection
- Has an allergy to the dye used in the procedure
- Is having heavy uterine bleeding
To reduce pain during the procedure, you may want to take pain medication in advance. Discuss this with your doctor. In some cases, he or she also may prescribe an antibiotic for you to take before HSG.
You should not drive right after an HSG. Arrange to have someone take you home.
 During a hysterosalpingography, an X-ray machine is placed over your abdomen. This allows the doctor to see the fluid inside your organs on a TV-like screen.
Photo reprinted with permission from Hollingsworth D, Resnick R, eds. Medical Counselling Before Pregnancy. New York: Churchill Livingstone, 1988;213–48 |
The Procedure
For HSG, a special fluid is placed into the uterus and tubes. The fluid shows up in contrast to these structures on an X-ray screen. This highlights their inner size and shape. For the procedure:
- You will be asked to lie on your back with your feet placed as for a pelvic exam. A device called a speculum is inserted into the vagina to hold the walls of the vagina apart and allow a view of the cervix. The cervix is cleaned.
- The end of the cervix may be injected with local anesthesia (pain relief). You may feel a pinch or tug as this is done.
- A device is inserted to hold the cervix steady. A thin tube then is passed through the cervical opening to the lower part of the uterus.
- An X-ray machine is placed over the abdomen. This allows the doctor to see the fluid inside your organs on a screen.
- The fluid slowly is placed through the thin tube into the uterus and fallopian tubes. The fluid causes the uterus to stretch. This may cause uterine cramping. Also, if the tubes are blocked, the fluid will cause the tubes to stretch. This may cause pain.
- X-ray images are made as the fluid fills the uterus and tubes. You may be asked to change positions a number of times for X-rays. If there is no blockage, the fluid will spill slowly out the far ends of the tubes. After it spills out of the tube, the fluid is absorbed by the cells lining the abdomen.
After the Procedure
Many women have minor side effects after having HSG. These are not serious and go away after a day or two in most cases. Side effects may include:
- Sticky vaginal discharge as some of the fluid drains out of the uterus
- Cramps
- Feeling dizzy, faint, or sick to your stomach
- Slight vaginal bleeding
Talk to your doctor about what kind of medication you can take to relieve these symptoms. A pad can be used for the vaginal discharge. Do not use a tampon. If the discharge gets on your underwear or clothing, it may stain.
Your doctor may prescribe antibiotics for a few days after the procedure. If you are prescribed antibiotics, make sure you take all of them, even if you feel fine.
Risks and Complications
Severe problems are rare. They may include an allergic reaction to the fluid, injury to the uterus, or pelvic infection. Call your doctor if you have any of these symptoms:
- Vomiting
- Fainting
- Severe abdominal pain or cramping
- Heavy vaginal bleeding
- Fever or chills
Test Results
Your doctor will discuss the results of your HSG with you. Based on the results, further tests may be needed. If a problem is found, your doctor will talk with you about a treatment plan.
Finally...
HSG is a way to diagnose problems of the uterus and fallopian tubes. The risk of problems after HSG is low, but you should be aware of warning signs. Talk to your doctor if you have questions about this procedure.
Glossary
Anesthesia: Relief of pain by loss of sensation.
Endometriosis: A condition in which tissue similar to that normally lining the uterus is found outside of the uterus, usually on the ovaries, fallopian tubes, and other pelvic structures.
Fallopian Tubes: Tubes through which an egg travels from the ovary to the uterus.
Hysterosalpingography: A special X-ray procedure in which a small amount of fluid is injected into the uterus and fallopian tubes to detect abnormal changes in their size and shape or to determine whether the tubes are blocked.
Infertility: A condition in which a couple has been unable to get pregnant after 12 months of trying without the use of any form of birth control.
Miscarriage: The spontaneous loss of a pregnancy before the fetus can survive outside the uterus.
Uterus: A muscular organ located in the female pelvis that contains and nourishes the developing fetus during pregnancy.
This Patient Education Pamphlet was developed under the direction of the Committee on Patient Education of the American College of Obstetricians and Gynecologists. Designed as an aid to patients, it sets forth current information and opinions on subjects related to women's health. The average readability level of the series, based on the Fry formula, is grade 6–8. The Suitability Assessment of Materials (SAM) instrument rates the pamphlets as "superior." To ensure the information is current and accurate, the pamphlets are reviewed every 18 months. The information in this pamphlet does not dictate an exclusive course of treatment or procedure to be followed and should not be construed as excluding other acceptable methods of practice. Variations taking into account the needs of the individual patient, resources, and limitations unique to the institution or type of practice may be appropriate.
Copyright © November 2000 by the American College of Obstetricians and Gynecologists. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without prior written permission from the publisher.
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Hysterosalpingography (HSG) is a procedure used to diagnose certain problems of the uterus and fallopian tubes. HSG most often is used to see if a woman's tubes are partly or fully blocked. Blocked tubes are a common cause of infertility. HSG also is used to help find the cause of repeated pregnancy loss.
