What is a Hysterosalpingogram?

During your fertility workup, the physician may conclude that there is a physical problem with your fallopian tubes which or uterus which prevent or inhibit the passage of your eggs.

A hysterosalpingogram is an X-ray which permits the medical professional to visualize the inside of the uterus and fallopian tubes. The picture will reveal any abnormalities of the uterus as well as tubal problems such as blockage and dilation (hydrosalpinx). If sterilization reversal is planned, the point where the tubes are blocked can be seen. This helps to plan the reconstructive procedure.

The visualization occurs because the physician will inject a radio-opaque dye to coat the inner surfaces of the tubes. A small catheter is placed into the cervix and the dye is injected. You may feel heavy cramping during, and for several hours following this procedure. Expect a sticky vaginal discharge for a few days as the dye is expelled from the uterus. Use a pad or panty liner during this time to allow fluid to escape. Any dye that remains will be absorbed without any ill effect.

If the tubes are not blocked by scar tissue or adhesions, the dye will flow into the abdominal cavity. This is a good sign but it does not guarantee that the tubes will function normally. It does, however, give a rough estimate of the quality of the tubal structure and the status of the tubal lining.

Some cases where tubes appear to be blocked where they join the uterus, may in fact be normal. Blockage at this location may be due to spasm of the opening from the uterus into the tube or from accumulated debris and mucus at the opening. This condition is managed by passing a very thin catheter into the fallopian tube either at the time of hysterosalpingogram or during a hysteroscopic procedure.

A hysterosalpingogram may also demonstrate endometrial polyps, submucus fibroids, intrauterine adhesions (synechia), uterine and vaginal septa, uterine cavity abnormalities, or the after-effect of genital tuberculosis. The hysterosalpingogram may or may not be able to detect pelvic adhesions, mild hydrosalpinx, small polyps, endometriosis, tubal phimosis (clubbing of the fimbria at the end of the tube), or immotility of the tube. Other tests, such as hysteroscopy saline sonohysterography or laparoscopy may be necessary to accurately evaluate your uterus.

Although the purpose of the hysterosalpingogram is not therapeutic, sometimes forcing dye through the tube will dislodge any material which blocks it. A number of women have become pregnant following a hysterosalpingogram without further treatment.

Generally there is no special preparation needed for this test. Depending on your diagnosis, you may need to take antibiotics to guard against infection. To ensure that you are not pregnant, the study is done between Day 7 and 10 of your cycle. Prior to the procedure you may take anti-inflammatory medications (Aleve or Motrin).

NOTE: Be sure we are aware of any allergies you may have to Iodine, Betadine, or Novocaine prior to the procedure.

If cramping does not subside or if you develop severe abdominal pain or fever following this test, please notify your clinic.