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Hysterosalpingogram -HSG

HSG is an X-ray of the uterus and tubes in order to diagnose a blockage of one or both tubes that may prevent union of the sperm and egg (fertilization). In addition, this procedure gives a picture outline of the uterine cavity and may help in detecting abnormalities of the uterus that may cause infertility, repeated miscarriages, or abnormal vaginal bleeding.

The HSG is an outpatient procedure performed in the radiology department. A special iodine-containing dye is injected through your cervix. It flows into the uterine cavity and through the tubes. If the tubes are not blocked, the dye will spill out of the tubes into the pelvis indicating that the tubes are open. X-ray pictures will be taken during the procedure to provide a permanent record of the condition of the tubes and the uterine cavity. The actual progress of the dye flowing through the tubes can be followed on a fluoroscopy TV monitor. HSG is performed between 7th and 10th day of the cycle

The procedure may cause some cramping and discomfort. Most patients do well when taking 2 tablets of extra strength Tylenol.

To undergo an HSG, the patient first lies flat on an X-ray table. A vaginal speculum is then inserted (much like the speculum insertion during a Pap smear). A small plastic tubing is passed through the cervix with the tip of the catheter inside the uterus.

What are the Complications and Side Effects of a Hysterosalpingogram?

During the insertion of the instruments and injection of the dye, there will likely be cramping and discomfort which usually disappears after a few minutes. A small percent of patients may experience prolonged discomfort, especially when the tubes are blocked and the liquid dye is unable to flow out of the uterus promptly.

A small percentage of patients may develop infection of the lining of the uterus, tubes or pelvis following this procedure. This is more common when the tubes have been damaged previously by infection or other causes. Infection in the tubes could lead to infertility, but the risk of infection is low (commonly estimated at 1%). If your HSG shows blockage of the tubes, you may be issued an antibiotic prescription to help prevent subsequent infection.

Allergic reactions are possible after injection of the iodine-based dye There is some evidence in the medical literature that conceptions rates may be greater in the cycles immediately following an HSG.

After Having a Hysterosalpingogram:

  • There will be slight vaginal bleeding and/or discharge for a few days after the procedure. If bleeding increases or persists more than a few days, call your physician.
  • There may be moderate pain or cramping for several hours after the procedure. If the pain increases or persists overnight, call your physician.
  • Fever (temperature> 100.5 degrees F) with persistent pain may indicate the possibility of early infection. These symptoms should be reported to your physician or to the Emergency Room immediately.
  • Douching, vaginal intercourse, or use of tampons should be delayed until 48 hours after the procedure.