Hysterosalpingography – When And Why is it Done?

It is also known as uterosalpingography or fluoroscopy. A water-soluble and contrast element is used to give an internal view of the uterus. This makes the interpretation of a radiologist easier.

When is Hysterosalpingography Considered?

Hysterosalpingography is considered when the woman is facing pregnancy problems. It aids to figure out:

• Uterus shape and structure
• How much the fallopian tube is open
• Uterine cavity scarring
• Inspection of the reasons for miscarriages because of congenital defects

This test also helps to find out the problems in uterine such as:

• Tumor masses
• Uterine fibroid
• Blocked fallopian tube
• Adhesions

Hysterosalpingography also helps to examine the results of tubal surgeries, which include:

• Infection, scarring, or blockage in the fallopian tube
• Closure of fallopian tube during sterilization and its reversal
• Fallopian tube re-opening which was blocked because of sterilization or disease
• Tubal ligation

[Read : 9 Most Common Causes Of Miscarriage]

Does the HSG Test Increase Chance of Pregnancy?

It is found that many women with unexplained infertility used to get pregnant within three to six months after HSG. It is assumed that the fallopian tube, being repeatedly flushed during this process, will get rid of the debris while HSG is performed. This naturally will increase the chance of pregnancy.

It is also found out that the pregnancy rate is high in cases that used oil-based contrast is used in HSG procedure when compared to the procedures that use water-based contrast.

Who Should Not be Considered For HSG?

A pregnant woman who is having one or more of the below-mentioned conditions should avoid having this test:

• Untreated STD or Sexually Transmitted Diseases
• Urinal bleeding during the test
• Pelvic infection
• Recent allergies or illness or medical conditions
• If the woman has some active inflammatory conditions in the pelvic region at the time of the procedure.

Unless you have any of the aforementioned conditions, your doctor might recommend you to have hysterosalpingography.

How Does the Procedure Work?

During the process of hysterosalpingography, the fluoroscopy machine passes X-ray beams continuously that create the moving image, and that image is recorded with a detector, and afterward, it gets projected with the help of a monitor.

In the uterine cavity, a contrasting element is injected, which makes the area seem dark. This dark image then converted to white electronically, which helps the radiologist to examine the movement of the organs. Moreover, the images can be saved as digital files on a computer.

What Equipment is Used For This Procedure?

Here is some of the equipment used for this test:

• A Speculum
• A monitor which works as a television
• A couple of x-ray tubes
• A detector
• A radiographic table

How Should You Prepare For HSG?

This process is generally executed a week after your menstruation but before ovulation. This eliminates any chances you have for pregnancy. Here are some of the ways you can prepare for this procedure:

• You will have to take an enema or laxative in order to clear the bowls one day before the tests so that the uterine cavity becomes visible clearly.
• You will take an over-the-counter medication to relieve any discomfort you are having at the time of the test.
• If you have any sort of allergies with something applied on your skin, then it is better to inform the technician before starting the process.
• You will also have to remove your jewelry, dental accessories, or eyeglasses to prevent metals from interfering with X-rays. Moreover, you will be advised to wear a gown at the beginning of the test.

How is HSG Done?

The whole procedure of HSG takes only less than half to three-quarters of an hour.

• The patient will have to lie back along with her knees bent.
• A speculum is then gets inserted into the vagina, which separates the vaginal walls in order to get the cervix visible.
• After the cleaning of the cervix, a local anesthetic drug medicine injected.
• Now, a catheter or cannula is inserted into the vagina, which carries the contrast element in the fallopian tube, peritoneal cavity, and uterus. For a blocked fallopian tube, the fluid will stretch it.
• After this, the speculum will be removed, and you will face the X-ray machine where the fluoroscopic camera will capture the digital images.
• For any defects, you will be asked to wait for about half an hour to obtain the images, which will be a good indication of any abnormality.
• Your doctor might ask you to change your positions for a proper view.
• Once the image capturing is over, the catheter gets removed.
• To find about scarring, an X-ray will be done on the next day of the test.

In case a potential abnormality gets detected, it will be advised to have follow-up tests to check your progression with the treatment.

What Will You Experience During and After the Procedure?

Women who have had hysterosalpingography will experience the following symptoms:

• Cramps similar to menstrual cramps
• Abdominal pain
• Dizziness
• Vaginal discharge
• Vaginal bleeding

When to Call the Doctor?

This test is minimally invasive and has fewer risks. But if you find the following symptoms then you have to call your doctor immediately:

• Allergy because of contrast material
• Pelvic infection
• Uterine injury
• Vomiting
• Fainting
• Breathing problems
• Fever
• Severe abdominal pain
• Severe cramps
• Heavy vaginal bleeding
• Foul-smelling vaginal discharge

What Are the Limitations of Hysterosalpingography?

Here are some of the limitations of hysterosalpingography:

• This test fails to detect uterine wall problems as well as problems with pelvic structure and ovaries.
• It fails to identify all the possible causes of infertility.

[Read : Polycystic Ovary Syndrome]

Are There Any Alternatives to HSG?

Are There Any Alternatives To HSG

Here are some of the alternatives of hysterosalpingography:

• Laparoscopy
• Hysteroscopy
• Sonohysterography

Finally, hysterosalpingography is a safe procedure, and it is often gets recommended by the doctors except for some exceptional cases. Therefore, if you have any doubts about this test, you can have a detailed conversation with your doctor.

Read Also: Hysteroscopy For Infertility – How Does It Improve Fertility?