• the right doctor
• basal fertility testing
• female symptoms
• additional tests for women
  • transvaginal ultrasound
  • sono-hystergram
  • hysterosalphingography (HSG)
  • hysteroscopy
  • laparoscopy
  • endometrial biopsy
  • immunoubead test
• female diagnosis
• male symptoms
• additional tests for men
• male diagnosis
• unexplained subfertility

hysterosalphingography (HSG)

This examination is often used to closely examine the uterus (womb) and the fallopian tubes. A hysterosalpingogram (HSG) is an x-ray of the uterus (hystero) and the tubes (salpingo). Through the combination of x-ray technology and x-ray contrasting fluid that is introduced into the female reproductive organs, HSG offers the best method to observe the inner workings of the organs.

• reason for the examination
• the examination

reason for the examination

Hysterosalpingography enables a doctor to judge whether the fallopian tubes of a woman are open, swollen or blocked. This test also enables an evaluation to be made of the size, shape and structure of the uterus.

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the examination

An HSG normally takes place in the radiological department and lasts approximately 15 minutes. The actual x-ray is very quick, but the necessary preparation, such as introducing the instruments, takes more time. There are different instruments involved in the procedure. However, the first step is always the same - a speculum is introduced and the cervix is disinfected, generally with iodine. Then the cervix is gripped with a small pair of forceps in order to hold it in position. You might feel this as a pricking sensation.

Then, using another instrument, a special dye, either oil- or water-based, is introduced through the cervix into the uterus. When the pressure is increased, this fluid travels through the fallopian tubes and eventually into the abdominal cavity. This helps in the examination of the form and structure of the uterine cavity, as well as assessing whether the fallopian tubes are open or blocked. Step-by-step, a number of x-rays are taken to follow the route of the fluid; the results are often called a ‘fill and spill’ as the coloured fluid fills the cavity and spills out through the ends of the tubes, confirming that these are open (or not). As a reaction to this test, the tubes may sometimes tense up and falsely appear blocked. Therefore, definite results can only be achieved if the examination occurs normally. If there are abnormalities in an HSG, a visual operation will usually be carried out subsequently in order to confirm or refute the results.

Amongst the possible side-effects are:

• Cramp (comparable to menstrual pain)
• Vaginal blood-loss (generally short-term)
• Light-headed feeling or sometimes fainting for a short time (so-called vasovaginal collapse)

Very rarely, complications may arise:

• Allergic reaction to the colorant
• Infection

Sometimes antibiotics are prescribed to avoid infections resulting from the procedure. You may also be advised to take a painkiller before hand, which will limit any discomfort. According to experts, HSG may flush out the fallopian tubes, possibly straighten the tubes, stimulate the cilia in the tubes or improve the cervical mucus. Doctors are currently investigating this in closer detail.

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