Hysterosalpingogram (HSG)
A hysterosalpingogram (HSG) is a diagnostic imaging test that helps evaluate the shape of your uterus and whether your fallopian tubes are open. This test is commonly performed as part of a fertility evaluation to help identify potential causes of infertility, such as blockages or abnormalities in the uterus or fallopian tubes.
The HSG test is a crucial component of fertility evaluation and can provide an explanation for struggles conceiving and can be helpful for building the best treatment plan when pursuing pregnancy.
What is an HSG?
HSG is a type of X-ray that uses contrast dye to create a clear image of your uterus and fallopian tubes. By gently introducing the dye through the cervix and into the uterus, your care team can assess how the dye flows through the reproductive tract. If the dye flows freely, it typically indicates that the tubes are open. If the dye is blocked or delayed, this may signal a structural issue that could affect your ability to conceive.
When is HSG recommended?
Your physician may recommend HSG as part of your initial fertility workup, particularly if:
- You’ve been trying to conceive without success
- You have a history of pelvic infections, endometriosis or fibroids
- You’ve had prior surgery involving the uterus or fallopian tubes
- You’re preparing for fertility treatment like IUI or IVF
The test provides valuable information that can help shape your treatment plan.
What to expect during the procedure
HSG is typically scheduled during the first half of your menstrual cycle, after your period ends but before ovulation, typically between days 5-12 of the menstrual cycle.
Here’s what the process usually looks like:
- You’ll lie on an exam table; a speculum is inserted to visualize the cervix exactly like a pap smear at the OBGYN office.
- A thin catheter is placed at the base of the cervix and a contrast dye is gently introduced through the catheter while X-ray images are taken. This allows for visualization of the uterine cavity and fallopian tubes.
- The entire procedure typically takes less than 10 minutes.
While the test is generally well tolerated, some patients experience cramping or discomfort similar to menstrual cramps. If your fallopian tubes are blocked, the discomfort may be more intense. Over-the-counter pain relief may be recommended beforehand to ease any cramping.
Understanding your results
After the procedure, the provider who is performing the exam will review the results with you. Based on the results, your physician may:
- Confirm that your uterus and fallopian tubes appear normal
- Identify a uterine abnormality, such as a polyp or fibroid
- Detect one or both blocked fallopian tubes
If an issue is found, your doctor will explain the next steps and how it may impact your fertility care plan. In some cases, additional imaging or surgical evaluation may be recommended.
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Your care team is here to guide you
At IVF Florida, we believe diagnostic testing is an important step in building clarity and confidence for your fertility journey. Your care team will coordinate the scheduling of your HSG, review your results in detail, and walk you through every part of the process.