HSG (Hysterosalphingogram)

A Hysterosalpingogram (HSG) is a diagnostic imaging procedure used to evaluate the health of a woman’s uterus and fallopian tubes. It is commonly recommended for women who are experiencing difficulty conceiving or have a history of recurrent miscarriages. The test helps identify issues such as blocked fallopian tubes, uterine abnormalities, and other potential causes of infertility.

What Is an HSG?

An HSG involves injecting a special contrast dye (radiopaque dye) into the uterus through the cervix. X-ray images are then taken to see how the dye flows through the uterus and fallopian tubes. This provides valuable information about the shape and structure of the uterus and whether the fallopian tubes are open or blocked.

Why Is an HSG Performed?

The procedure is commonly recommended in the following situations:

• Infertility Evaluation: To check for structural problems in the uterus or blocked fallopian tubes, which can prevent conception.
• Recurrent Miscarriages: To rule out any anatomical issues that may contribute to repeated pregnancy loss.
• Pelvic Pain: To investigate possible causes of unexplained pelvic pain or menstrual irregularities.
• Post-Surgical Monitoring: After surgeries such as tubal ligation reversal, to assess the condition of the fallopian tubes.

How Is an HSG Performed?

1. Preparation

   • The procedure is typically performed in the first half of the menstrual cycle, usually after menstruation ends and before ovulation.
   • It’s advisable to take a mild pain reliever like ibuprofen 30–60 minutes before the procedure to reduce any discomfort.
   • The patient is asked to lie on an examination table, similar to a pelvic exam position.

2. Insertion of the Contrast Dye

   • A small speculum is inserted into the vagina to visualize the cervix.
   • A catheter is gently inserted through the cervix into the uterus. The contrast dye is then injected through the catheter into the uterine cavity.

3. X-ray Imaging

   • As the dye flows into the uterus and fallopian tubes, X-ray images are taken.
   • The images help determine if the fallopian tubes are open, whether the uterus has any abnormalities (like fibroids or polyps), and the shape of the uterine cavity.

4. Completion

   • After the images are taken, the catheter is removed, and the procedure is completed in about 15-30 minutes.
   • The patient may experience some mild cramping or spotting after the procedure, which usually resolves within a few hours.

What Does an HSG Reveal?

An HSG can provide valuable information about:

• Blocked Fallopian Tubes: The dye will not flow through blocked tubes, which is a major cause of infertility.
• Uterine Abnormalities: Such as fibroids, polyps, adhesions, or congenital uterine anomalies that could affect fertility.
• Hydrosalpinx: A condition where a blocked fallopian tube fills with fluid, which can impair fertility.
• Endometrial Problems: Certain conditions, like endometrial polyps or scarring, may be visible.

Benefits of an HSG

• Non-Surgical Diagnostic Tool: An HSG is a relatively non-invasive procedure that provides critical information about the reproductive system.
• Helps Diagnose Fertility Issues: It’s especially useful in diagnosing causes of infertility, such as blocked fallopian tubes or uterine abnormalities.
• Improves Fertility: In some cases, the procedure can clear minor blockages in the fallopian tubes, increasing the chances of conception.
• Quick and Effective: The procedure is typically completed within 30 minutes and does not require an overnight stay.

Considerations & Risks

• Discomfort and Pain: Some women may experience mild to moderate cramping during or after the procedure, but this is usually temporary.
• Allergic Reactions: Although rare, some women may experience an allergic reaction to the contrast dye.
• Infection: There is a slight risk of infection, especially if the procedure is not performed under sterile conditions.
• Radiation Exposure: As with any X-ray procedure, there is a small amount of radiation exposure, but it is generally considered safe for most women.

After the Procedure

• Mild Cramping: It’s common to experience mild cramping and spotting after an HSG, but this usually subsides within a day.
• Follow-Up: Your doctor may recommend a follow-up appointment to discuss the results and determine the next steps in your fertility treatment plan.

Conclusion

A Hysterosalpingogram (HSG) is an important diagnostic tool that helps identify blockages or abnormalities in the fallopian tubes and uterus, two common causes of infertility. The procedure is relatively quick and non-invasive, with a high diagnostic value in helping doctors understand fertility issues.