Issues such as blocked fallopian tubes may lead to infertility in women. Therefore, finding out the root cause is crucial to getting the right treatment. One of the tests which can help identify the cause(s) is known as a hysterosalpingogram or HSG test. Read all about the HSG test, associated benefits, and the reasons why it may be prescribed.
What is a hysterosalpingogram or HSG test?
Hysterosalpingogram or HSG test is an X-ray imaging test to check the uterine cavity of women. The test helps in diagnosing issues related to the uterus or the fallopian tubes. Generally, this procedure is used to find the causes of infertility in women, which can be due to blocked fallopian tubes, abnormal menstrual cycles, or uterine problems. Women can undergo this procedure after menstruation and before ovulation.
When is an HSG test needed?
An HSG test helps identify blockages in the fallopian tubes. An open fallopian tube is necessary for the free movement of the sperm to the ovum for fertilization. The blockage can restrict this movement leading to infertility. The test can also check whether there is any abnormality vis-à-vis the shape of the uterus.
Additionally, the test may also check for the success of the tubal ligation procedure. Tubal ligation is a birth control measure wherein the fallopian tubes are tied or blocked to restrict the movement of the sperm into the fallopian tube.
The doctors can prescribe other tests if irregularities are found during the HSG test.
What are the benefits of the HSG test?
HSG test has several benefits, which include:
- It is a non-invasive procedure. Therefore, no incisions are made during the procedure.
- This is a short procedure lasting only up to five minutes.
- Using this method, almost all the issues related to the uterine cavity can be discovered.
- The patient can leave the hospital on the same day as the procedure.
- Apart from assisting in proper diagnosis, the flushing of oil-based contrast medium into the tubes required for the test can clear the tubes, thus improving the chances of pregnancy.
How is the HSG procedure conducted?
The patient is given pain medications and antibiotics an hour prior to the procedure, to relieve the pain and avoid infections.
This is a short procedure wherein the patient lies down on the table with her legs apart. A device called a speculum can be inserted into the patient’s vagina to keep it open. The cervix is then cleaned and a small tube called a cannula is inserted through the cervix. Once the cannula is in place, the speculum will be removed.
A liquid that contains iodine may be pumped into the uterus through the cannula. The iodine contrasts with the uterus and appears white in the x-ray images making it easier for the doctor to identify irregularities in the uterine walls and fallopian tubes.
The dye won’t get pumped into the tubes if they are blocked. This way the doctor can recognize whether there exists an issue with the fallopian tubes. Once the imaging is complete, the cannula is removed and the liquid is drained out.
In extremely rare cases, the test can cause the following :
- Dye induced allergic reaction.
- Injury to the pelvic region due to the instruments used.
- One may observe heavy vaginal bleeding, unpleasant odour in vaginal discharge, fainting, and severe pain, among others after the procedure.
What to expect after the HSG test?
If the results of the test indicate that the patient’s tubes are blocked, then the healthcare provider may recommend a surgical procedure such as laparoscopy to directly view the tubes or bypass the tubes and perform in vitro fertilization (IVF). This is a complex decision that should be discussed in detail with your doctor and your partner.
Some patients may experience mild cramps during and after the procedure. But if it intensifies, then they might need to contact the healthcare provider to check for the cause. Vaginal spotting can be observed for a few days after the procedure. A sanitary pad can be used if this occurs. Discomfort in the stomach and dizziness due to the dye are also normal.
The patient undergoing the procedure can go back home on the same day and can resume normal chores. But, it is advisable to refrain from intercourse for a few days to avoid infections and irritation.
What are the risks associated with the HSG test?
Even though a hysterosalpingogram is a procedure with minimal risk, however, there are certain complications that can be caused due to this test. The patient undergoing this procedure may get an allergic reaction due to the contrast dye used during the procedure. There are chances of the pelvic region getting injured with the speculum or other instruments used.
One may observe heavy vaginal bleeding, unpleasant odour in vaginal discharge, fainting, and severe pain, among others after the procedure. The doctor should be contacted immediately if any of these symptoms are observed.
Hysterosalpingogram is a simple and effective test to diagnose issues related to the reproductive system of women. A hysterosalpingogram is used mostly to determine whether there is any blockage in the fallopian tubes. It is advisable to avoid the procedure if one has a pelvic infection since it might worsen the infection.
Frequently Asked Questions
What is the next step if tubes are found to be blocked?
If a woman’s tubes are found to be blocked, the doctor is highly likely to recommend either a surgical procedure (laparoscopy) to directly view the tube or bypass the tube and perform in vitro fertilization (IVF).
Is the procedure uncomfortable?
It generally causes mild to moderate uterine cramping for about 5 to 10 minutes. But some women experience cramps for several hours. These can be reduced with the help of medications.
Does the procedure enhance the chances of fertility?
There is no conclusive evidence of this. However, certain studies show a slight increase in fertility lasting about 3 months after a normal HSG test. Most doctors perform this test purely for diagnostic purposes.