HSG – Hysterosalpingogram

What is a Hysterosalpingogram (HSG), and why do I need one?

A Hysterosalpingogram is a special X Ray dye (contrast) test to show whether your fallopian tubes are open (not blocked). This may help us to establish the reason you are not getting pregnant and decide appropriate treatment for you.

What does the Xray not tell us?

The HSG Xray is unable to tell us whether you have adhesions (scar tissue) around your fallopian tubes or endometriosis. This can only be diagnosed by laparoscopy.

How do I make the appointment for a Hysterosalpingogram?

If you are recommended to have an HSG following your consultation at BCRM, we will arrange a private referral to Southmead Hospital X-ray department. You will be asked to telephone phone Southmead Hospital X-ray department on the 1st or second day of your period. The best time to perform the test is as soon as possible after your period has finished. If you do not normally have periods, or if they are very irregular, please inform the department so that a suitable appointment can be made. It is very important that we do not X Ray you if there is the slightest chance that you may be pregnant, as this puts the pregnancy and you at risk of complications. We advise not to have sexual intercourse from the start of the period until after the X-Ray.

How is it done?

The procedure is undertaken in the X Ray department. It will involve you lying on the X Ray table in a position like when you have a smear. A speculum will be placed into your vagina. A small tube attached to a syringe will then be used to inject the special X Ray “dye” (which is a colourless liquid) into the uterus and tubes. X Rays will be taken as the “dye” is injected. The examination will take approximately 15 minutes. It is advisable to bring some sanitary protection to use following the procedure, as you may experience some bleeding for a few hours. You will often also be prescribed antibiotics to take on the day of the test.

Will it hurt?

When the tube is inserted into your cervix you may feel some discomfort but this often wears off quite quickly.. When the “dye” is injected you may feel a “period type” pain but this usually fades as soon as the examination is finished. As you may experience some discomfort during the test we very much suggest that you take a couple of painkillers, eg: Paracetamol or Nurofen (or both) about one hour before your appointment.

What will I be told on the day?

The Doctor or Radiographer may be able to give you a brief idea of what the X Ray has shown. We recommend you book an appointment at BCRM to discuss the results.

What are the risks from the procedure?

If you are pregnant: the procedure could cause a miscarriage, and the x rays could harm a developing baby. This is why we book your appointment, whenever possible, after a period.
Infection:
the risk of an infection following the procedure is approximately 1 in a 100 cases. If we feel you are at particular risk we will prescribe antibiotics to be taken following the procedure.
Allergy:
it is extremely rare to have an allergic reaction to the x ray “dye”, but if you have any known allergies you must inform the doctor or radiographer before the procedure.
Fainting:
occasionally you may feel “faint” during or after, so we advise you to lie down for a few minutes
Metformin:
If you are taking this medication, you will be asked to stop it for 2 days following the test. This will be explained to you.