The hysterosalpingogram (HSG) is performed soon after menstruation has ended and before ovulation occurs. The patient will generally call to schedule the test on the first day of her cycle, in order to properly time the procedure. This timing is important, since the thin walls provide a potentially better view of the uterus, and there is a low likelihood of pregnancy at this point in a woman‘s cycle.
Preparing
Due to cramping, which may occur with the injection of the dye (particularly if there is a blockage), the doctor may suggest a full dose of over-the-counter pain medication to be taken by the patient just prior to the HSG procedure. The physician or the facility involved may also require a pregnancy test, since the radiation directed at the uterus could be harmful to a developing baby. Additionally, the physician may require a test for infection and/or the administration of a round of antibiotics prior to the hysterosalpingogram.
Procedure
The entire procedure takes place within 5-30 minutes. The patient will most likely be asked to dress in a hospital gown and position herself on a table with stirrups. The doctor may perform a brief pelvic exam and will then:
- Insert a speculum into the vagina
- Insert a catheter (or cannula) through the cervix and into the uterus
- Inject a dye into the uterus
- Take several x-rays of the uterus and fallopian tubes
During the procedure, the doctor may ask the patient to change positions for additional angles of the structures.
Risks
Since the procedure may cause discomfort and lightheadedness, doctors often recommend that the patient does not drive home from the procedure. Patients also commonly experience spotting after the HSG. Therefore, a woman should not be concerned, unless she experiences unusually heavy bleeding or develops a fever over 100° F. Problems are rare and include allergic reaction (to the iodine dye) and infection.
Results
The doctor performing the procedure will have the results immediately. Although, the patient may have to wait a day or two for the interpretation of those results. In a normal scan, the dye will fill the uterus and spill out of the end of the fallopian tubes. The dye will highlight any blockages, structural abnormalities or other problems, such as:
- Polyps
- Fibroids
- Scar tissue
- Abnormal growths
If the hysterosalpingogram reveals a blockage, structural abnormality or other condition, the doctor will discuss potential treatment options with the patient.
Benefits
There are a few studies that suggest a potential for increased fertility in the months following the procedure. The studies are controversial, however, so the procedure is not generally performed for the purpose of enhanced fertility.
Alternative Tests
Alternative tests may be performed instead of the hysterosalpingogram. These include the similar sonohysterogram and the more invasive, hysteroscopy.
