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.
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.
FAQ
The primary purpose of an HSG is to identify potential causes of infertility (such as one or more blocked fallopian tubes). However, depending on the cause of your infertility, an HSG may improve your likelihood of becoming pregnant by clearing minor blockages from your fallopian tubes.
If the source of your infertility is not revealed during your HSG, your doctor may recommend other infertility treatments.
The cost of an HSG can vary widely, depending on whether you have insurance and what type of coverage you have. For the average uninsured person, the cost of an HSG test typically ranges from $600 to $1,800. Geographical location can also affect the price of this procedure.
If you are insured, it is important to review your coverage information or talk to your insurance provider about whether the costs of an HSG qualify for coverage. Many insurance policies will not pay for HSGs because they consider them to be infertility treatments. To avoid being saddled with unexpected bills, take the time to figure out in advance if you will be responsible for most or all your HSG procedure costs.
An HSG procedure uses a catheter to inject contrast dye into the uterus and fallopian tubes. The catheter is thin and is placed inside the cervix to help deliver the dye to the right areas (uterus and fallopian tubes) for infertility diagnosis.
Only a small amount of contrast dye is needed to highlight blockages in the fallopian tubes. Suppose you have a tilted or retroverted uterus. In that case, it may be more difficult for your doctor to insert the catheter into the uterus, and you may feel a slight pinching sensation during the process.
Contrast dye is used during an HSG. This type of dye highlights certain organs in X-ray images when it is injected or swallowed. In the case of an HSG, the dye is injected into the uterus where it enters the fallopian tubes.
Contrast dye does not dye your organs. It will either leave your body or dissolve safely in the body. If you’ve ever had an allergic reaction to contrast dye or barium, let your doctor know before receiving an HSG.