Hysterosalpingogram (HSG)

What is a Hysterosalpingogram?

A hysterosalpingogram (HSG) is a 15-minute office procedure that checks for abnormalities of the fallopian tubes and/or uterine cavity. It is a real-time X-ray that can identify issues such as blocked fallopian tubes, scar tissue, polyps, fibroids, or other problems contributing to infertility. You may wish to get a hysterosalpingogram, or your doctor may recommend this procedure if you are having trouble getting pregnant.

What to Expect: Hysterosalpingogram Procedure & Procedure


When you receive a hysterosalpingogram, you can expect to go through the following process:

Step 1: Your doctor will instruct you to lie on an examination table and put your feet in stirrups.

Step 2: A fluoroscope will be positioned over your pelvis, taking x-rays of your reproductive tract.

Step 3: Your doctor will place a speculum in the vagina, clean the cervix, and possibly give you a local anesthetic to help minimize procedural discomfort.

Step 4: A small catheter will be inserted into the opening of your cervix.

Step 5: Contrast material will be sent through the catheter into the uterus and through the fallopian tubes. Your doctor will monitor the flow of the dye throughout this process. You may be asked to slightly change positions so different angles of the uterus, and fallopian tubes can be captured on X-ray.

Step 6: If any intrauterine abnormalities are present (such as fibroids or polyps), the dye will outline them. If there are no obstructions in the fallopian tubes, the dye will be able to pass through the tubes easily.

Step 7: If the dye shows signs of blockages or damage in the fallopian tubes, your doctor will provide you with a diagnosis and treatment recommendations after reviewing the images.

You may experience cramping during the examination. However, the discomfort should quickly subside when the procedure is finished.

How do I prepare for a hysterosalpingography procedure?

If you’re having trouble getting pregnant and want to rule out possible issues with your fallopian tubes, a hysterosalpingogram may be recommended by your doctor. Ideally, you should receive an HSG test between days five and 14 of your menstrual cycle. This is after your period ends but before ovulation occurs. To prepare for your HSG, consider doing the following:

  • Take an over-the-counter pain reliever approximately one hour before your test to alleviate any cramping you may experience.
  • Take prescribed antibiotics before your procedure if your physician advises.
  • Remove any jewelry before your procedure (metal can interfere with the X-ray).

Do not have intercourse, douche, or use tampons within the first 24 hours following your HSG procedure. Take Tylenol or ibuprofen as needed for cramping and discomfort.

hysterosalpingogram uterus diagram
hysterosalpingogram video

Interpreting Hysterosalpingogram Results

When the HSG is done, your RMA doctor will immediately review the results of the HSG test with you and make recommendations for proceeding with fertility treatment. The HSG may reveal the cause of infertility or even remove the cause of infertility if the dye successfully clears any minor blockages from the fallopian tubes.


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