A hysterosalpingogram (HSG) is an X-ray procedure used to see whether the fallopian tubes are patent (open) and if the inside of the uterus (uterine cavity) is normal. An HSG can assist your doctor in identifying abnormalities in your reproductive anatomy that may prevent you from conceiving.
When does a hysterosalpingogram occur?
Your provider will schedule your procedure after the menstrual period ends but before you
ovulate (cycle day 5-10).
Who must not receive a hysterosalpingogram?
If you are pregnant or have a pelvic infection, you should not undergo an HSG.
What Can You Expect From A Hysterosalpingogram?
An HSG is an outpatient procedure that takes under five minutes.
During the procedure, your physician will inject a dye-containing fluid into your uterus and fallopian tubes while an X-ray is taken.
Getting ready for the dye injection
A woman is positioned under a fluoroscope (x-ray imager that will take pictures during the study)
Your provider will introduce a speculum tool into your vagina to expand it and give access to your cervix.
Your doctor will clean your cervix and a device (cannula) is placed into the opening of the cervix. Alternatively, your supplier may employ a thin plastic tube with a balloon at the end. Once within your body, the balloon inflates to hold the dye injection tube in place.
Injecting the Die
The doctor gently fills the uterus with a liquid containing iodine (a fluid that can be seen by x-ray) through the cannula. The contrast will be seen as white on the image and can show the contour of the uterus as the liquid travels from the cannula, into the uterus, and through the fallopian tubes.
As the contrast enters the tubes, it outlines the length of the tubes and spills out their ends if they are open.
Abnormalities inside the uterine cavity may also be detected by the doctor observing the x-ray images when the fluid movement is disrupted by the abnormality.
After taking enough X-ray images, your physician will remove the cannula or plastic tube containing the balloon from your body without reinserting the speculum.
After the HSG, a woman can immediately return to normal activities, although some doctors ask that she refrain from intercourse for a few days.
How To Prepare For A Hysterosalpingogram?
To prepare for your procedure, follow the instructions provided by your provider. Your provider may advise you to:
An HSG usually causes mild or moderate uterine cramping for about 5-10 minutes. However, some women may experience cramps for several hours.
An hour before your treatment, take ibuprofen 800mg. This can be over the counter Advil.
If you are unable to take aspirin or ibuprofen you can take two acetaminophen (tylenol) tablets.
What are the risks and complications of HSG?
HSG is considered a very safe procedure. However there is a set of recognized complications, some serious, which occur in less than 1% of the time.
Infection- the most common serious problem with HSG is pelvic infection. This usually occurs when a woman has had previous tubal disease (such as a past infection of chlamydia). In rare cases, infection can damage the fallopian tubes or make it necessary to remove them. A woman should call her doctor if she experiences increasing pain or fever within 1-2 days of the HSG.
Fainting- rarely the woman may get light-headed during or shortly after the procedure
Radiation exposure- radiation exposure from an HSG is very low, less than with a kidney or bowel study. This exposure has not been shown to cause harm even if a woman conceives later the same month
Iodine allergy- rarely a woman may have an allergy to the iodine contrast used in HSG. A woman should inform her doctor if she is allergic to iodine, intravenous contrast dye, or seafood. Women who are allergic to iodine should have the HSG procedure performed without an iodine-containing contrast solution. If a woman experiences a rash, itching, or swelling after the procedure, she should contact her doctor.
Spotting- spotting sometimes occurs for 1-2 days after HSG.
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