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What is a Hysterosalpinogogram?

  A hysterosalpingogram, or HSG is an important fertility test of female for tubal patency and normalcy of the uterine cavity.

The HSG test is a radiology procedure usually done in the radiology department of a hospital (or outpatient radiology facility). Radiographic contrast (dye) is injected into the uterine cavity through the vagina and cervix. The uterine cavity fills with dye and if the fallopian tubes are open the dye will fill the tubes and spill into the abdominal cavity.

This determines if the fallopian tubes are open or blocked and whether the blockage is located at the junction of the tube and uterus (proximal) or whether it is at the other end of the fallopian tube (distal). These are the areas where the tube is most commonly blocked. Very successful treatment for tubal factor infertility is available.
 

What to expect during a hysterosalpingogram

  The hysterosalpingogram study only takes about 5 minutes to actually perform. However as the test is usually done in the radiology department of a hospital there is additional time for the woman to register at the facility and fill out a questionnaire and answer some questions regarding allergies to medication etc. The way the test is done is the following:
Canadian fertility clinic The woman lies on the table on her back and brings her feet up into a "frog leg" position.
Canadian fertility clinic The doctor places a speculum in the vagina and visualizes the cervix.
Canadian fertility clinic Either a soft, thin catheter is placed through the cervical opening into the uterine cavity or an instrument called a tenaculum is placed on the cervix and then a narrow metal cannula is inserted through the cervical opening.
Canadian fertility clinic Contrast is slowly injected through the cannula or catheter into the uterine cavity. An x-ray picture is taken as the uterine cavity is filling and then additional contrast is injected so that the tubes should fill and begin to spill into the abdominal cavity. More x-ray pictures are taken as this "fill and spill" occurs.
Canadian fertility clinic When both tubes spill dye, the woman is often asked to roll to one side or the other slightly to give a slightly oblique x-ray image which can further delineate the anatomy.
Canadian fertility clinic The procedure is now complete. The instruments are removed from the cervix and vagina.
Canadian fertility clinic The woman usually remains on the table for a few minutes to recover from the cramping caused by injection of the contrast.
Canadian fertility clinic The results of the test can be immediately available. The x-ray pictures can usually be reviewed with the woman several minutes after the procedure is done.

 

Complications?

  Complications associated with a hysterosalpingogram include the possibility of an allergic reaction to the dye, which is uncommon. This usually manifests as a rash, but can rarely be more serious. Pelvic infection or uterine perforation are also possible complications. Both of these are very uncommon.

If a woman has multiple sexual partners or is otherwise at risk for sexually transmitted diseases, she might be screened with cervical cultures before doing an HSG. Some physicians prescribe several days of antibiotics to reduce risk of infection after HSG.
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