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A hysterosalpingogram (HSG) is a diagnostic procedure performed by a doctor. The doctor uses x-ray imaging to exam a women’s uterus, fallopian tubes, and pelvic surroundings.

Purpose of an HSG

Imagine a healthy, young woman who is wishing for nothing more than to be a mother. So, she and her partner decide to try for a baby. Months go by without anything happening. This woman is beginning to feel hopeless and has seen more negative pregnancy results than she cares to remember. She makes an appointment with her doctor who then tells her that they need to perform a hysterosalpingogram.

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The woman looks at her doctor with a confused look on her face and says, ‘A what?’A hysterosalpingogram, or HSG for short (phew!) is a diagnostic x-ray procedure used to examine a woman’s uterus, fallopian tubes, and the areas surrounding them. A hysterosalpingogram, sometimes called a uterosalpingogram, is typically performed when a woman is having trouble getting pregnant or has had multiple unexplained miscarriages. There are several reasons a woman may have difficulty getting pregnant. Some of these include:

  • Structural abnormalities of the uterus
  • Blockage in the fallopian tube(s)
  • Scar tissue in the uterus or fallopian tubes
  • Uterine fibroids, tumors, polyps, or adhesions

Since an HSG is performed using x-ray imaging, a doctor is able to see any of these abnormalities a woman may have that are preventing her from becoming pregnant.Remember the young woman from earlier? Let’s assume that after her HSG, her doctor discovers that she has a blocked fallopian tube.

Since they know the reason for this woman’s infertility, she can now receive the treatment needed to correct it and hopefully become pregnant in the future.

HSG Procedure

Since an HSG is not advised during pregnancy, it is important that an HSG is performed right after a woman’s period ends and before she ovulates.Many women are given a mild sedative before their HSG to help them relax during the procedure. A doctor will use a speculum, which is a tool used to visualize the vagina and cervix, to place a very small tube through the cervix and into the uterus. The doctor will then inject a dye through this tube and use an x-ray to watch this dye flow from the uterus through the fallopian tubes.

An x-ray is a photographic or digital image of the internal structure of an object, usually a body part. The pictures obtained during the procedure can diagnose abnormal uterine structure or injury and blocked fallopian tubes.A blockage of the tubes could prevent an egg moving through the fallopian tube to the uterus. Likewise, a blockage could also prevent sperm from being able to join with the egg. A blockage in even just one of the fallopian tubes would greatly decrease a woman’s ability to become pregnant. You can compare this to a kink in a water hose that affects the water’s ability to pass through freely.

An HSG can also identify problems inside the uterus that could prevent a pregnancy.

Risks and Side Effects

As with any procedure, there are some risks and side effects associated. Those associated with an HSG include:

  • Mild pain during or after the procedure
  • Light bleeding for two to three days following the procedure
  • Feeling of light-headedness or faintness during or after the procedure
  • Exposure to a small amount of radiation. Anytime there is an exposure to radiation, there is a chance of damage to cells or tissues
  • Pelvic infection
  • Inflammation of the endometrium or the fallopian tubes
  • Possible damage or puncture to the uterus or fallopian tubes
  • Allergic reaction to the iodine in x-ray dye
  • In cases where an oil-based dye is used, there is a potential for the oil to leak into the bloodstream and cause a clot. If this clot travels to the lung, then a pulmonary embolism (PE) can occur

Lesson Summary

An HSG is a radiologic procedure performed by a doctor.

It is usually performed on women who are having difficulty getting pregnant and is used to identify such problems as uterine abnormalities and blocked fallopian tubes. It is performed using a small tube inserted through the cervix into the uterus where x-ray dye is injected. While the risk of side effects is relatively small, a few can occur, including exposure to radiation, infection, mild pain, allergic reaction to the x-ray dye, light-headedness or faintness, and light bleeding for two to three days following the procedure.

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