For a hysterosalpingogram (HSG) test, a radiologist works in conjunction with reproductive physicians to determine if the uterine cavity has a normal shape and if the fallopian tubes are open. The procedure is performed in the radiology department and uses X-rays to assess the cavity. While the procedure can take 10-15 minutes to set up, the actual time that the patient is undergoing the x-ray procedure is about one to two minutes.
A speculum, the same instrument used for Pap smear exams, is used to open the vagina so the cervix can be viewed. Then, two instruments are attached to the cervix in order to fill the uterine cavity and fallopian tubes with the liquid contrast. Several pictures are taken, during which the woman may be required to shift positions to achieve the right view, and then the instruments are removed. The doctor generally will review the films immediately after the procedure so the results will be known right away. It is generally recommended, however, that all studies be completed at the initial clinic visit to review at a subsequent clinic visit.
Although rare, risks of the procedure include allergic reaction to the dye, developing an infection caused by the procedure, and damage to the pelvic structures from instruments.
Women may experience cramping while the uterus is filled with fluid, although usually for only about 15 minutes afterward. It is normal for some women to experience mild cramping for one to two days, accompanied by a light discharge and some vaginal spotting or bleeding. Women will usually be instructed to take ibuprofen about an hour before the procedure to reduce cramping and antibiotics for three days around the time of the procedure to reduce the risk of infection. The doctor will provide instructions on post-procedure care and activities.
This test is generally done between day 6 and 12 of a woman’s menstrual cycle. The test cannot be performed if a woman is pregnant, has an active pelvic infection, or is allergic to iodine or the x-ray dye.