Hysterosalpingogram (HSG)

University of Iowa Health Care specialists use a hysterosalpingogram (HSG) to test for infertility in women.

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Infertility in women has many causes. Some causes involve the uterus or fallopian tubes.

If you're having trouble getting pregnant or have had miscarriages, your gynecologist might recommend a hysterosalpingogram (HSG).

An HSG is a specific kind of X-ray that uses contrast dye. It lets your provider see whether your fallopian tubes are fully open and if the inside of your uterus looks normal.

Your HSG will show:

Scar tissue or polyps inside the uterus
Certain types of uterine fibroids (non-cancerous tumors of the uterus)
Blocked or swollen fallopian tubes
Scar tissue in and around the pelvis

An HSG is also sometimes used to check the success of a tubal ligation or tubal ligation reversal.

After your HSG, your OBGYN or reproductive endocrinology care team will use the results to make a personalized care plan.

Having an HSG at UI Health Care

Your HSG should take place between the end of your period and your next ovulation. The best time to call to schedule your HSG is on the first day of your period.

During an HSG, some people experience cramping similar to menstrual cramps. Before your procedure, you may want to take over-the-counter pain medication like ibuprofen or acetaminophen.

What to expect

An HSG is an outpatient procedure, performed while you're awake. You'll be able to go home after your test.

From start to finish, your appointment will take about 60 to 90 minutes. The test itself takes between 10 and 30 minutes, most of which is the setup for the test. The actual flush of the tubes takes less than a minute.

When you arrive, a nurse will do a urine pregnancy test to make sure you're not pregnant.
You'll lie on a table with your knees bent and legs open, as for a pelvic exam.
Your provider will place a speculum into your vagina to see your cervix, then put a thin tube inside your cervix. Special contrast will flow through the tube into your uterus and fallopian tubes.
The X-ray machine above the table will take images that show how well the contrast flows. In a normal HSG, the contrast dye will fill the uterus and flow out of each fallopian tube. Your body harmlessly absorbs the dye afterward.

The provider performing your HSG will look at the images and give you preliminary results right away.

Later, the images will be reviewed by a UI Health Care reproductive endocrinologist.

After that review, your provider will talk with you about the next steps.

They might recommend a minimally invasive procedure (laparoscopy) to get a closer look at what's causing a blockage. They could also recommend fertility treatments like in vitro fertilization (IVF).