Hysterosalpingogram (HSG)

A Hysterosalpingogram (HIS-teh-roh-sal-PING-oh-gram) (HSG) is a test that lets your doctor examine the inside walls of your uterus and fallopian tubes. This minor procedure is designed to provide information about the shape and contour of the endometrial cavity (uterus) or to document the presence of endometrial polyps, leiomyomata (fibroids), or scarring. In addition the procedure will determine whether the fallopian tubes are patent (open).

A hysterosalpingogram (HSG) is a test that uses x-rays and a contrast agent/dye to detect scar tissue, polyps, fibroids and other growths that may be blocking your tubes or preventing a fertilized egg from implanting properly in your uterus.

What to Bring

• Your physician order
• Personal identification
• Insurance card(s)
• Medication list

How to Prepare for Your HSG Exam

• If there is any chance you may be pregnant, your exam should be postponed.
• The test is usually done between days 6-10 of your cycle. This is to ensure that you are not pregnant when the HSG is performed.
• Make a list of any allergies you may have, especially to Iodine, Betadine or Novocaine. Allergic reactions to the contrast dye are rare, but can occur. Be sure to tell your doctor if you have ever had an adverse reaction to any of the above. There are some alternate contrast materials that can sometimes be used in these cases, as well as other testing options.
• On the day of the test, take an anti-inflammatory pain medication such as Advil or Motrin an hour before the procedure. It is common to experience some mild to heavy cramping as the catheter is inserted, and pre-medicating with a painkiller can help minimize discomfort. You may want to take another dose later in the day, after the procedure.

• Wear comfortable clothes. You may feel a bit tender after the procedure, so soft, non-restrictive clothing is best.

• If there is any possibility that you are pregnant, you should always inform your x-ray technologist.
• If you have an on-body device (insulin pumps, insulin regulators, Neulasta, other chemo pumps, etc), you must inform your Radiologic Technologist. These devices cannot be in the x-ray room during your exam.

• Leave all valuables at home.
• You will be given a gown to wear during the procedure. You may be asked to remove jewelry, glasses and any metal objects or clothing that might interfere with the x-ray images.

What to Expect

• A Radiology Nurse will call you a few days prior to your appointment to explain the process of the HSG procedure.
• Upon arrival to the hospital, you will be required to take a (UPT) urine pregnancy test before the HSG.
• HSG procedure is done in the Radiology department by the Radiologist and a female Radiologic Technologist.
• You will be required to read and sign a PATIENT CONSENT TO MEDICAL TREATMENT for the HSG procedure.
• The entire process/procedure is usually completed within 45 minutes to an hour.

What will I experience during and after the procedure?

• The Radiologist will insert a sterile pre-lighted disposable speculum into your vagina (like when you have a Pap smear), and then clean the cervix with Betadine solution. Then a very small catheter is placed inside your cervix that will lead to your uterus and fallopian tubes.
• Contrast dye will be injected through the catheter. The contrast should fill your uterus and fallopian tubes and spill out of each fallopian tube.
• You may feel some cramping, especially when the contrast dye is injected. You may even feel some intense pain if you have a blocked fallopian tube.
• X-rays will be taken, so that the Radiologist can evaluate your uterus and fallopian tubes. You may be asked to tilt your hips side to side for better visualization of the fallopian tubes. The procedure takes between 10-30 minutes.
• A sanitary pad will be provided for you, but you may bring your own pad with you. A small amount of spotting is normal after an HSG test, and there can also be leakage of the contrast dye. Wearing a pad for the rest of the day will help protect your clothing. You may need to wear a pad for a few days as the dye is slowly expelled from the uterus.
• Think about asking someone to drive you home. Most patients are able to drive themselves home after an HSG, but if you are not feeling well you might appreciate having someone there to drive.
• Consider taking the day off. While an HSG test is not a major procedure, going back to work afterwards may not be appealing. Some women find that cramping and spotting continues throughout the day. Feelings of dizziness or nausea are also possible. If you can, take a little time to recover and pamper yourself after the test.
• You should recover very quickly and be back to your normal activities by the next day. The risks of the HSG include pain or discomfort, infection, and vaginal spotting or bleeding. Contact your doctor if you experience any of the following symptoms after the HSG: heavy bleeding, lower abdominal pain, foul smelling discharge or temperatures over 100ºF.
• Undergoing an HSG test may not be a very pleasant experience; however it can often provide the answers you are looking for. As an added bonus, a small number of women find that they become pregnant naturally soon after their HSG. This is probably that the flow of the dye dislodged a minor blockage such as an endometriosis lesion, freeing up the fallopian tube for normal operation.

IMPORTANT NOTE:
On rare occasions, a woman may have an allergy to the iodine contrast used in an HSG. Patients with documented allergies to iodine, intravenous contrast dyes, or shellfish should make that know to the physician prior to the procedure. Other risks associated with an HSG include pain or discomfort, infection, and vaginal spotting or bleeding. Contact your referring physician if you develop a fever or continue to feel pain for more than a few days. Patients should also call their referring physician if they experience any of the following symptoms after the HSG: heavy bleeding, lower abdominal pain, foul smelling discharge or temperatures over 100ºF.