Southern California Reproductive Center (SCRC) is pleased to introduce our Gynecoradiology Suite, offering Hysterosalpingograms (HSG) as part of our commitment to comprehensive fertility care.
A Hysterosalpingogram (HSG) is a special fluoroscopic x-ray procedure to evaluate the patency (openness) of the fallopian tubes and the shape of the uterine cavity. Here are some frequently-asked questions about HSG:
HSG is an important diagnostic component of the basic infertility evaluation because a major cause of infertility is blocked fallopian tubes – and that’s what HSG is excellent at revealing. Other indications for HSG may also include recurrent miscarriages, abnormal vaginal bleeding, or suspected uterine anomalies. At SCRC, we often perform the HSG procedure before tubal ligation reversal surgery to demonstrate residual tubal length.
Having your HSG performed by a fertility specialist like those at the Southern California Reproductive Center is preferable to undergoing the procedure at your local ob/gyn because the fertility specialist has a keen eye for reading and interpreting HSG test data on a regular basis; this familiarity with the HSG procedure will help ensure an accurate diagnosis.
HSG is an outpatient procedure that can be completed in less than half an hour. HSG is performed in the follicular phase of the menstrual cycle (before ovulation), after menstruation has stopped. A thin catheter is inserted into the cervix and uterus to allow injection of radio-opaque contrast media (a dye that helps show the outline of the fallopian tubes under x-ray). As the dye moves through the uterine cavity, HSG provides a series of fluoroscopic images to demonstrate filling of the uterine cavity and fallopian tubes.
The three terms sound similar, so it can be confusing. A hysteroscopy examines the uterine cavity with an endoscope. This procedure often uses a general anesthetic, and is can be more difficult for the patient than HSG. Hysteroscopy has largely been replaced by the sonohysterogram, which is also called a hysterosonogram (HSN) or a saline ultrasound. The sonohysterogram allows us to see uterine abnormalities using sound waves to create a picture instead of X-rays, as in the HSG.
HSG can reveal uterine or fallopian tube abnormalities that impair fertility. Because tubal disease, such as adhesions or scar tissue, is responsible for approximately 20% of infertility cases, HSG should be completed early in the workup of infertility. In addition, some studies have demonstrated increased pregnancy rates in patients who undergo a normal HSG. This may be simply because when the contrast medium is injected into the area by catheter, the flow of the dye sometimes dislodges whatever is blocking the fallopian tubes, e.g. endometriosis lesions.
Often, we will advise a patient who is about to begin fertility treatment with Clomid or hCG (gonadotropin) to have an HSG first, especially if she has a history of endometriosis or other tubal problems. We want to see a good, dynamic, open flow, also referred to as tubal patency, before we induce ovulation. You don’t want to start an IVF cycle and run into an unforeseen problem later that could have been detected by HSG
Women may have mild to moderate cramping during the HSG procedure; however it is rare to experience severe pain from HSG. A possible side effect is allergy to the dye, which contains iodine, so if you know you have an iodine allergy, make sure to tell your fertility doctor prior to having your HSG. Infection is a very rare side effect; tell your doctor if you experience pain several days after the HSG procedure, as this may be a sign of infection.
HSG may be helpful in the diagnosis process, but the first step toward getting an accurate diagnosis is to schedule a consultation with a dedicated SCRC fertility specialist. To make that happen, simply call us at (800) 600-9112 or click here to contact us, and one of our friendly fertility counselors will be happy to help you with making the appointment or answering any questions you might have.