25/07/2023 - 18:52

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Hysterosalpingography: How, When, Why?

Hysterosalpingography (HSG) is a diagnostic medical procedure used to examine the health of the female reproductive system, particularly the uterus and fallopian tubes. It involves the use of X-rays and a contrast agent to visualize the internal structures of the reproductive tract. Here's a breakdown of the procedure, including when and why it's performed:

How is Hysterosalpingography (HSG) performed?


Before the procedure, the patient may be asked to take a pregnancy test to ensure they are not pregnant. It is usually scheduled after menstruation but before ovulation to avoid any potential interference with early pregnancy.

2-Contrast Agent

During the procedure, a radiologist or gynecologist will insert a speculum into the vagina to visualize the cervix. Then, a small catheter is inserted through the cervix and into the uterine cavity. A contrast medium (a dye) is then injected through the catheter, filling the uterine cavity and flowing into the fallopian tubes.

3-X-ray Imaging

As the contrast medium flows through the uterus and fallopian tubes, X-ray images are taken. The contrast material helps outline the shape of the uterus and fallopian tubes, making it possible to identify any abnormalities, blockages, or structural issues.


Once the X-rays are complete, the catheter is removed, and the patient may be monitored for a short time before being discharged. Some women may experience mild cramping or discomfort after the procedure, but it generally subsides quickly.

When is Hysterosalpingography (HSG) performed?

HSG is typically performed in the early follicular phase of the menstrual cycle, which is the days right after menstruation but before ovulation. This timing ensures that there is a low risk of performing the procedure during an early pregnancy and also provides the opportunity to assess the patency of the fallopian tubes in preparation for a potential conception in the current or subsequent cycles.

Why is Hysterosalpingography (HSG) performed?

HSG is conducted for various reasons, including:

1- Infertility Investigation

It is commonly used as part of the evaluation for infertility issues. By examining the uterus and fallopian tubes, it can identify factors that may be hindering conception, such as structural abnormalities or tubal blockages.
Uterine Abnormalities: HSG can detect abnormalities in the shape and size of the uterus, such as uterine fibroids, polyps, or adhesions (Asherman's syndrome).

2-Fallopian Tube Blockages

The procedure can determine if there are any blockages or obstructions in the fallopian tubes that may prevent the egg from reaching the sperm or the fertilized egg from traveling to the uterus.

3- Recurrent Miscarriages

For women who experience recurrent miscarriages, HSG can help identify potential anatomical causes that may be contributing to the pregnancy losses.

4- Confirmation of Tubal Ligation Success

In cases where a woman has undergone tubal ligation (a form of permanent contraception), HSG can confirm the success of the procedure and check for any tubal patency.
It's important to note that while HSG is generally a safe and effective diagnostic tool, there are some risks involved, such as allergic reactions to the contrast agent or infection. Before undergoing the procedure, it's essential to discuss any concerns and potential risks with the healthcare provider.

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