HSG Test for Infertility: Procedure, Advantages and Side effects

by | Jul 1, 2023 | Fertility

What is a Hysterosalpingogram?

A hysterosalpingogram, commonly referred to as an HSG test, is a diagnostic test used to evaluate the shape and condition of a woman’s uterus and fallopian tubes. It is a valuable tool in the assessment of fertility issues and can help identify any potential obstacles to conception. This procedure involves the use of X-rays and a contrast dye to obtain detailed images of the reproductive organs.

 

When is a Hysterosalpingogram Test Required?

  • Assessing Fertility Concerns: If you and your partner have been struggling to conceive, your healthcare provider may recommend a hysterosalpingogram. This test can provide valuable insights into the potential causes of infertility. It allows doctors to identify any structural abnormalities, such as blockages in the fallopian tubes or uterine abnormalities, which might hinder the fertilization process.
  • Evaluating Recurrent Miscarriages: Recurrent miscarriages can be emotionally devastating for couples. In some cases, a hysterosalpingogram can help uncover underlying factors contributing to recurrent pregnancy loss. By examining the shape and condition of the uterus, this test can assist in diagnosing issues like uterine fibroids, polyps, or scar tissue that may increase the risk of miscarriages.
  • Confirming Tubal Sterilization: For women who have previously undergone tubal sterilization, a hysterosalpingogram can confirm the success of the procedure. The test can ensure that the fallopian tubes are blocked, providing reassurance that permanent contraception has been achieved.

 

When is the Best Time to Have an HSG Test?

The optimal time to undergo a hysterosalpingogram test depends on various factors, including your menstrual cycle and any potential fertility treatments you may be pursuing. Typically, the procedure is scheduled between days 6 and 10 of your menstrual cycle, counting the first day of your period as day 1. It is important to avoid scheduling the test while you are menstruating or if you suspect you might be pregnant, as this could interfere with the accuracy of the results.

If you are undergoing fertility treatments, such as in vitro fertilization (IVF), your doctor will coordinate the timing of the HSG to ensure it aligns with your treatment plan. Communication with your healthcare provider is crucial to determine the most suitable timing for your specific situation.

 

How Do I Prepare for a Hysterosalpingogram Test?

Before undergoing a hysterosalpingogram, there are several essential steps you can take to ensure a smooth and successful procedure.

  1. Consultation with Your Healthcare Provider: The first step is to schedule a consultation with your healthcare provider. They will discuss the procedure with you in detail, addressing any concerns or questions you may have. This is an opportunity to share your medical history, including any allergies, previous surgeries, or existing health conditions, which could impact the test or the use of contrast dye.
  2. Medication and Allergies: Inform your doctor about any medications you are currently taking, including over-the-counter drugs, as certain medications may need to be temporarily discontinued before the test. It is also essential to mention any known allergies, particularly to iodine or shellfish, as the contrast dye used in the procedure contains iodine.
  3. Timing and Menstrual Cycle: As mentioned earlier, the timing of the hysterosalpingogram test is crucial. It is typically performed after your menstrual bleeding has completely stopped but before ovulation occurs. Your healthcare provider will guide you on the appropriate timing based on your individual circumstances.
  4. Pain Relief and Support: Some women may experience mild discomfort or cramping during the hysterosalpingogram test. Taking a pain reliever, such as ibuprofen, before the procedure can help alleviate any potential discomfort. It can also be helpful to have a trusted friend or family member accompany you to provide emotional support throughout the process.

 

How Does the HSG Procedure Work?

  1. Before the Procedure: On the day of the hysterosalpingogram, you will be asked to change into a hospital gown and lie on an examination table. A radiology technologist or radiologist will perform the procedure, usually in a radiology department or fertility clinic.
  2. Insertion of a Speculum: Similar to a regular pelvic examination, a speculum will be inserted into your vagina to provide access to the cervix. This may cause mild discomfort or pressure, but it is generally well-tolerated.
  3. Catheter Placement and Contrast Injection: Once the speculum is in place, a thin catheter will be gently inserted through the cervix and into the uterus. The contrast dye will then be slowly injected through the catheter into the uterus. The dye fills the uterus and spills into the fallopian tubes, allowing the radiologist to capture X-ray images.
  4. X-ray Imaging and Observations: As the contrast dye flows through the reproductive organs, the radiologist will capture a series of X-ray images. These images provide a detailed view of the shape, size, and condition of the uterus and fallopian tubes. You may be asked to change positions during the procedure to ensure comprehensive imaging.
  5. Completion of the Procedure and Follow-up: Once the necessary images have been obtained, the catheter will be removed, and the procedure will be complete. Some women may experience mild cramping or spotting afterward, but these symptoms typically subside quickly. Your healthcare provider will discuss the findings of the test with you and recommend appropriate next steps based on the results.

 

How Do I Prepare for a Hysterosalpingogram test?

  1. Consultation and Information Gathering: Before your HSG test, you’ll likely have a consultation with your healthcare provider. This is an opportunity to discuss any medical conditions, allergies, or concerns you may have. Your doctor will explain the procedure in detail, addressing your questions and providing necessary instructions.
  2. Medications and Allergies: Inform your healthcare provider about any medications you are currently taking. Certain medications, such as blood thinners, may needed to be temporarily discontinued before the test. Additionally, if you have any known allergies, particularly to iodine or shellfish, it’s crucial to mention them, as the contrast dye used in the HSG contains iodine.
  3. Timing and Menstrual Cycle: The optimal time for an HSG test is usually between days 6 and 10 of your menstrual cycle, counting the first day of your period as day 1. However, your doctor will provide specific instructions based on your individual circumstances. It’s important to avoid scheduling the test during your period or if you suspect you might be pregnant, as this could affect the accuracy of the results.
  4. Preparation Steps: On the day of the HSG test, you may be advised to have a light meal before the procedure. It’s also essential to empty your bladder before the test begins. Wearing loose and comfortable clothing can help you feel more at ease during the process.

 

What to Expect During the HSG Test?

  • Setting and Positioning: The HSG test is usually performed in a radiology department or fertility clinic. You’ll be asked to change into a hospital gown and lie on an examination table. A radiology technologist or radiologist will be present to perform the procedure.
  • Insertion of a Speculum: Similar to a regular pelvic examination, a speculum will be gently inserted into your vagina to provide access to the cervix. This may cause mild discomfort or pressure, but it’s generally well-tolerated.
  • Catheter Placement and Contrast Injection: Once the speculum is in place, a thin catheter will be carefully inserted through the cervix and into the uterus. The contrast dye will then be slowly injected through the catheter into the uterus. The dye fills the uterus and spills into the fallopian tubes, allowing for X-ray imaging.
  • X-ray Imaging and Observations: As the contrast dye flows through your reproductive organs, X-ray images will be captured. These images provide detailed visualization of the shape, size, and condition of your uterus and fallopian tubes. You may be asked to change positions during the procedure to ensure comprehensive imaging.
  • Duration of the Procedure: The entire HSG procedure typically takes around 15 to 30 minutes, although this may vary depending on individual circumstances. The radiologist or technologist will guide you through each step and inform you about what is happening throughout the process.

 

Is a Hysterosalpingogram Painful?

The level of discomfort experienced during an HSG test varies from person to person. Some women may only feel mild cramping, while others may experience more significant discomfort. Taking a pain reliever, such as ibuprofen, before the procedure can help alleviate any potential discomfort. It can also be helpful to communicate with the healthcare provider performing the test, as they can provide guidance and support.

  • Recovery and Aftercare: After the HSG test, you may experience some minor spotting or vaginal discharge. It’s advisable to use sanitary pads instead of tampons during this time.
  • Lower Abdominal Pain After HSG Test: It’s not uncommon to experience mild lower abdominal pain or cramping after an HSG test. However, if the pain persists or intensifies, or if you develop a fever or unusual symptoms, it’s important to contact your healthcare provider promptly.
  • Returning to Regular Activities: Most women can resume their regular activities, including work, the day after the HSG test. However, it’s essential to follow any specific aftercare instructions provided by your healthcare provider. These instructions may include avoiding sexual intercourse or using contraception for a certain period following the test.

 

Advantages of the HSG Test

  • Assessing Uterine and Tubal Health: One of the primary advantages of the HSG test is its ability to evaluate the health of your uterus and fallopian tubes. The contrast dye used during the procedure allows for clear visualization of the internal structures, enabling the radiologist to identify any abnormalities or potential issues that may be affecting fertility. This information can be crucial in determining the appropriate course of treatment or further investigations.
  • Identifying Blockages and Structural Anomalies: The HSG test is particularly useful in detecting blockages or structural abnormalities within the reproductive system. If there are any obstructions in the fallopian tubes, the test can provide a detailed image, helping your healthcare provider diagnose the cause and plan appropriate interventions. Additionally, the HSG can reveal uterine abnormalities such as polyps, fibroids, or adhesions, which may affect fertility or increase the risk of pregnancy complications.
  • Confirming Tubal Patency: For women who are trying to conceive, knowing if the fallopian tubes are open and functioning properly is crucial. The HSG test can confirm tubal patency by showing the passage of the contrast dye through the tubes. This information can help determine the best approach to achieve pregnancy, whether through natural conception or assisted reproductive techniques.

 

What to Expect After the HSG Test

Immediate Aftereffects: After the HSG test, it is common to experience mild cramping or discomfort. Some women may also notice slight vaginal spotting or discharge. These immediate aftereffects are usually temporary and should subside within a day or two. It is advisable to use sanitary pads instead of tampons during this time.

Resuming Normal Activities: In most cases, you can resume your regular activities shortly after the HSG test. While the test itself is generally well-tolerated, it’s important to listen to your body and avoid strenuous physical activities for a day or two, if needed.

 

Side Effects of the HSG Test

  • Allergic Reactions: In rare cases, some individuals may experience an allergic reaction to the contrast dye used during the HSG test. If you develop symptoms such as hives, itching, difficulty breathing, or swelling, it is crucial to seek immediate medical attention.
  • Infection and Pelvic Inflammatory Disease (PID) : Although uncommon, there is a small risk of developing an infection after the HSG test. To minimize this risk, your healthcare provider may prescribe antibiotics to take before or after the procedure. It’s important to adhere to the prescribed medication regimen and promptly report any signs of infection, such as fever, abdominal pain, or unusual vaginal discharge.
  • Lower Abdominal Pain: It is not unusual to experience mild lower abdominal pain or cramping for a short period after the HSG test. This discomfort typically resolves on its own or can be managed with over-the-counter pain relievers. However, if the pain is severe, persistent, or accompanied by other concerning symptoms, it’s important to consult your healthcare provider.

Also Read: How Much Does HSG Test Price/Cost in 2023?

Can an HSG Test Increase the Chance of Pregnancy?

While an HSG test is primarily a diagnostic procedure, it can indirectly enhance the chances of pregnancy. By identifying and treating issues like blockages or abnormalities in the uterus and fallopian tubes, an HSG test can optimize the conditions for conception. If any obstacles are detected, your healthcare provider can recommend appropriate interventions, such as surgery or fertility treatments, to improve your chances of getting pregnant.

 

Symptoms of Pregnancy After an HSG Test

After undergoing an HSG test, it’s important to be aware of potential pregnancy symptoms. While the procedure itself does not cause pregnancy, the increased chances of conception can lead to pregnancy in the subsequent cycles. Some common early signs of pregnancy include:

  1. Missed Period: One of the most recognizable signs of pregnancy is a missed period. However, it’s important to note that missed periods can also be due to other factors, such as stress or hormonal imbalances.
  2. Breast Changes: Pregnancy can cause changes in the breasts, including tenderness, swelling, or darkening of the areolas.
  3. Nausea and Fatigue: Some women may experience morning sickness, which includes feelings of nausea and occasional vomiting. Fatigue and increased tiredness are also common symptoms during early pregnancy.

It’s important to remember that these symptoms can vary widely among individuals, and the presence or absence of these symptoms does not definitively confirm or rule out pregnancy. Taking a pregnancy test or consulting with a healthcare provider is the best way to confirm pregnancy.

 

Chances of Natural Pregnancy After an HSG Test

The chances of a natural pregnancy after an HSG test depend on various factors, including the underlying fertility issues, age, overall reproductive health, and the effectiveness of any interventions performed following the test. While an HSG test can improve the conditions for conception by addressing any identified issues, it does not guarantee a pregnancy.

Studies have shown that women who undergo an HSG test may have increased fertility rates in the first few cycles following the procedure. The flushing effect of the contrast dye used during the HSG test can potentially clear minor blockages in the fallopian tubes, improving the chances of natural pregnancy. However, the effectiveness of this effect may vary among individuals, and it’s important to consult with your healthcare provider to understand your specific situation.

 

Can an HSG Test Clear Blocked Tubes?

In some cases, an HSG test can help in clearing minor blockages in the fallopian tubes. The pressure created by the contrast dye during the procedure can dislodge or flush out small obstructions, potentially restoring tubal patency. However, it’s important to note that the effectiveness of the HSG test in clearing blocked tubes depends on the nature and severity of the blockage. In cases of significant or complete blockages, further interventions, such as laparoscopic surgery or fertility treatments, may be required to address the issue.

 

Reasons for Bleeding After an HSG Test

It’s not uncommon to experience light vaginal bleeding or spotting after an HSG test. This can be attributed to the manipulation of the cervix and the introduction of the contrast dye into the uterus. The bleeding is generally minimal and should resolve within a few days. If the bleeding is heavy, accompanied by severe pain, or persists beyond a few days, it’s important to contact your healthcare provider for further evaluation.

 

Conclusion

A hysterosalpingogram is an important diagnostic tool in assessing fertility and identifying potential obstacles to conception. While an HSG test itself does not directly increase the chance of pregnancy, it can indirectly improve fertility by identifying and addressing issues that may hinder conception. By providing a clear image of the reproductive system, an HSG test enables healthcare providers to develop appropriate treatment plans and interventions. Understanding the symptoms of pregnancy, the potential for natural conception, the ability of an HSG test to clear blocked tubes, and the reasons for post-procedure bleeding can empower you on your journey toward parenthood. Remember to consult with your healthcare provider for personalized guidance and recommendations based on your unique circumstances.

 

F.A.Q

Q: What is HSG test for?

A: HSG test, or Hysterosalpingogram, is a diagnostic procedure used to examine the uterus and fallopian tubes in women. It involves the injection of a contrast dye into the uterus, which helps visualize the reproductive organs on X-ray images.

Q: Which day is good for HSG test?

A: The optimal day for the HSG test depends on the individual’s menstrual cycle. It is usually recommended to schedule the test between days 7 and 10 of the menstrual cycle, counting the first day of menstruation as day 1.

Q: Is HSG test useful for pregnancy?

A: The HSG test is primarily a diagnostic procedure and not a treatment for pregnancy. However, it can provide valuable information about the condition of the uterus and fallopian tubes, which may help identify potential causes of infertility or recurrent miscarriages.

Q: Can HSG test increase fertility?

A: The HSG test itself does not increase fertility. However, it can detect certain abnormalities in the reproductive organs that may be affecting fertility. In some cases, if a blockage or other issue is identified during the test, further treatment or interventions may be recommended to improve fertility.

Q: What are the rules before HSG?

A: Prior to undergoing an HSG test, there are a few guidelines to follow:

  • Inform your doctor about any allergies, previous pelvic infections, or suspected pregnancy.
  • Schedule the test within the recommended timeframe of your menstrual cycle.
  • Take some prescribed medications as instructed by your healthcare provider.
  • Avoid sexual intercourse for some days before the test.

You may be advised to take over-the-counter pain medication before the procedure.

Q: Which is more painful, HSG or IVF?

A: The level of pain experienced during the HSG test and in vitro fertilization (IVF) can vary among individuals. Generally, the HSG test involves some discomfort or cramping, similar to menstrual cramps, while IVF procedures may involve more invasive steps and can cause discomfort or pain. It’s important to discuss any concerns about pain management with your healthcare provider.

Q: What is a normal HSG results?

A: A normal HSG result indicates that the contrast dye has flowed freely through the uterus and both fallopian tubes, without any obstructions or abnormalities. The dye should outline the shape of the uterus and spill out of the fallopian tubes into the abdominal cavity. Abnormal results may suggest issues such as blockages, uterine abnormalities, or tubal abnormalities that could affect fertility.

Q: Can I eat before HSG test?

A: It is generally recommended to have a light meal or snack a few hours before the HSG test. However, it’s important to follow the specific instructions provided by your healthcare provider, as they may have specific dietary restrictions for the procedure.

Q: How much rest is required after HSG test?

A: After the HSG test, it is advisable to take it easy and rest for the remainder of the day. The length of rest required can vary among individuals, but it is generally recommended to avoid strenuous activities or heavy lifting for at least 24 hours after the procedure.

Q: Is HSG test mandatory?

A: The HSG test is not mandatory for everyone. It is typically recommended for individuals who are experiencing fertility issues or recurrent miscarriages, as it can provide valuable diagnostic information. However, the decision to undergo the test is ultimately a personal one and should be discussed with a healthcare provider.

Q: How many hours is HSG test?

A: The HSG test itself usually takes around 15 to 30 minutes to complete. However, you may need to allocate additional time for preparation, paperwork, and recovery before and after the procedure. It’s best to consult with your healthcare provider to get a better estimate of the overall time needed.

Q: Can sperm survive HSG test?

A: The HSG test involves the introduction of a contrast dye into the uterus and fallopian tubes, which is not conducive to sperm survival. It is generally recommended to avoid sexual intercourse for a few days leading up to the HSG test, as well as for a short period afterward, to allow any potential discomfort or cramping to subside.

Q: Is HSG mandatory in IVF?

A: While the HSG test is not always mandatory for in vitro fertilization (IVF), it is commonly recommended as part of the fertility evaluation process. The HSG test helps assess the condition of the uterus and fallopian tubes, providing valuable information that can guide the IVF treatment plan.

Q: Does HSG delay the next period?

A: The HSG test itself does not typically delay the next menstrual period. However, some individuals may experience minor changes in their menstrual cycle or temporary spotting after the procedure. If you have concerns about your menstrual cycle or experience any unusual symptoms, it is best to consult with your healthcare provider.

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    Dr Mona Dahiya

    Dr Mona Dahiya

    IVF Specialist & Consultant

    Dr Mona Dahiya has performed over 5,000+ IVF cycles and is considered a global expert in IVF, ICSI, IUI and male fertility treatment. She is an eminent writer on Infertility Treatment and has over 100 Publications in both International and National Journals. Dr Mona Dahiya has immensely contributed to the field of infertility through her Research and articles.

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