A Hysterosalpingogram, commonly referred to as an HSG, is a specialized X-ray procedure designed to visualize the internal structure of the uterus and the patency of the fallopian tubes. This diagnostic tool involves the introduction of a contrast material, which allows these reproductive organs to be seen on X-ray images. It is frequently performed as part of an infertility investigation to identify any blockages or structural irregularities that might hinder conception.
Procedure Duration
The actual imaging portion of a hysterosalpingogram typically lasts 5 to 15 minutes, though some procedures may extend up to 45 minutes. The total time spent at the clinic or hospital, however, usually ranges from 1 to 2 hours. This longer appointment duration accounts for necessary steps such as patient registration, preparation, discussions with medical staff, and post-procedure instructions.
Preparing for Your HSG
The HSG procedure is typically scheduled after menstruation has ended but before ovulation, usually between days 5 and 12 of the menstrual cycle. This timing minimizes the chance of performing the procedure during an early pregnancy and ensures no menstrual bleeding interferes with the images. Taking an over-the-counter pain reliever, such as ibuprofen, about 30 to 60 minutes before the appointment can help reduce discomfort.
Inform your healthcare provider about any allergies, particularly to iodine or contrast dyes, before the procedure. You will also confirm your pregnancy status, often with a urine test, and may be advised to avoid unprotected intercourse from the start of your menstrual cycle until after the HSG. The procedure is not performed if a pelvic infection is suspected. Wearing comfortable clothing can contribute to ease during the visit.
During the HSG Procedure
During the HSG, you will lie on an X-ray table, positioned similarly to a routine gynecological examination. A speculum is gently inserted into the vagina for a clear view of the cervix, which is then cleansed. A thin, flexible catheter is carefully placed into the cervix and extends into the uterus.
An iodine-based contrast material is then slowly injected through the catheter, filling the uterine cavity and flowing into the fallopian tubes. X-ray images, using fluoroscopy, are captured as the contrast moves, allowing observation of the uterus’s shape and whether the fallopian tubes are open, letting the dye spill into the abdominal cavity. Patients commonly experience sensations similar to menstrual cramps or pressure as the dye fills the uterus and tubes. This discomfort can be more pronounced if there are blockages in the fallopian tubes.
After Your HSG
Following the HSG, it is common to experience mild cramping, light vaginal spotting, or a sticky discharge as the contrast material exits the body. Wearing a sanitary pad is recommended to manage any discharge and protect clothing, as the dye can stain. You can typically resume your normal daily activities immediately after the procedure.
Contact your doctor if you experience any concerning symptoms. These include a fever (e.g., above 100.5°F or 38°C), severe or increasing pain, heavy vaginal bleeding, or a foul-smelling vaginal discharge. Symptoms of an allergic reaction, such as hives or difficulty breathing, also warrant immediate medical attention. Preliminary results of the HSG are often provided immediately after the procedure, with full reports typically sent to your referring physician.