HSG Test

What is the HSG Test for Infertility – Procedure, Recovery & Results

HSG Test – Many delicate organs and tissues are involved in the process of reproduction. Female infertility can be caused by even the slight functioning of the reproductive system. One of them is a blocked fallopian tube. A fallopian tube plays a vital role in pregnancy. It is the location where the sperm meets the egg for fertilisation. If this tube is blocked, the sperm can not reach the egg for fertilisation and form an embryo.

There can be several reasons why your fallopian tubes are blocked. For instance, endometriosis, fibroids, past surgeries, ectopic pregnancy, and pelvic inflammatory disease can lead to blockage of one or both fallopian tubes. 

However, medical advancements have made it possible to overcome this issue of blocked fallopian tubes. A test called the HSG helps with the diagnosis of the underlying condition. 

In this article, we are going to discuss all about the HSG test for infertility. The entire procedure, recovery, and results that follow.

What is the HSG Test for Infertility?

Hysterosalpingography, or HSG, takes the help of a specialised X-ray test to see the internal shape of the uterine cavity and confirm whether one or both of the fallopian tubes are blocked. 

Hysterosalpingography can help identify the root cause behind infertility, abnormal vaginal bleeding, or recurrent miscarriage. It is also known as uterosalpingography and is carried out by a radiologist. 

Uterosalpingography test is also taken in the following cases:

  • Tubal ligation-Tubal ligation is a medical surgery to close the fallopian tubes. HSG is recommended to check whether the fallopian tubes have closed properly.
  • Reversal of Tubal ligation-: HSG test is also recommended to check if the fallopian tubes were reopened successfully.

What is the Need to Take the HSG Test?

The HSG test is often recommended for women with fertility issues as

  • It helps to analyse if both the fallopian tubes are open so that the egg and sperm can meet for fertilisation.
  • This test helps see if the uterus has a normal shape. 
  • Hysterosalpingography helps confirm the presence or absence of polyps, fibroids, or scar tissue in the uterine cavity. 

When is the HSG Test done? 

It is carried out 5-7 days after your periods are over but before ovulation. The ideal time will be during the first half of your menstrual cycle, i.e. between days 1 and 14. 

The reason for this is that after periods, the chances of conceiving are quite low. The first condition for the HSG test is that you should not be pregnant. Also, the risk of infection post-periods is lower.  

Who Should Not Take the HSG Test? 

Hysterosalpingography is a great treatment option to identify the reason behind infertility. However, HSG is not for everyone. 

  • If you are already pregnant, inform the doctor before undergoing HSG treatment, as it can be dangerous for the fetus. 
  • If you have pelvic inflammatory disease (PID), avoid having this test. 
  • If you have unexplained vaginal bleeding, HSG treatment should be avoided. 

Is the HSG Test Painful?

Yes, HSG can be slightly painful. But you will be given a painkiller like ibuprofen an hour before the procedure. A sedative or narcotic drug will also be prescribed if you are feeling anxious. An antibiotic before and after the HSG procedure helps prevent infection. 

If you were asked to take narcotics, it would be risky to drive home by yourself. So it’ll be better if you ask a loved one to accompany you for your HSG test. 

The nurse will ask you to remove any metal accessories you are wearing before the test. The reason behind this is that metal can interfere with the proper functioning of the X-ray machine.

Procedure for HSG

You will be asked to lie down in a frog leg position with your knees bent and feet spread under an X-ray imager known as a fluoroscope. Instead of creating still pictures, fluoroscopy helps produce a real-time video image. That’s the reason why fluoroscopy is also called live X-ray. It helps the radiologist check the movement of the dye in the reproductive system. 

A speculum will be inserted into your vagina to keep it open, and the cervix will be cleaned thoroughly with an antiseptic solution. You may feel a little discomfort or period-like cramps during this step. 

The cervix is the small canal or passage that connects your vagina with your uterus. 

After this, the speculum will be removed, and a thin tube known as a cannula will be inserted into the cervix. Then, a contrast liquid dye containing iodine is filled into the uterus and fallopian tubes.

What is a Contrast Dye?

Contrast dye is a substance that, when injected into your body, helps to highlight desired organs and tissues on the X-ray imager for examination. This dye will appear white on the machine. 

It will help the fertility specialist see the images of the uterus and the fallopian tube. If your fallopian tubes are blocked, this liquid dye won’t be able to enter inside the tubes. It also helps determine the location of the blockage. But if the tubes are open, then the dye will spill into your pelvis. 

You will be asked to move a little or change positions to capture different sides and angles of the uterus and fallopian tubes. 

After the fertility expert has got clear images, the cannula will be removed, and the procedure will be completed. This contrast dye will come out with your urine. 

The whole procedure of HSG takes about 5 to 10 minutes. 

The X-ray images are produced within a few minutes and highlight the presence of 

  • congenital uterine anomalies
  • polyps
  • tumours
  • fibroids 
  • uterine scar tissue in the uterine cavity. 

Apart from showing whether or not the fallopian tubes are blocked, the HSG also detects pelvic scar tissue in the abdominal region near the fallopian tubes. 

What can’t be analysed during HSG? 

The HSG can’t analyse the ovaries or treat endometriosis. Also, it won’t be able to highlight fibroids present outside the endometrial cavity, i.e. in the muscular or the outer part of the uterus. 

Some common signs of discomfort 

After the procedure is completed, you might feel some discomfort in your abdomen. You might also have the following side effects: 

  • Dizziness
  • Nausea
  • Cramps
  • Spotting

Risks involved in HSG test

The HSG test does not have major risk factors. But some risks that can be witnessed after the HSG procedure are: 

  • Allergic response towards the dye 
  • Injury to the uterine cavity, like perforation 
  • Fallopian tube or uterine lining infection

What happens after the HSG procedure

HSG is a relatively safe procedure; however, sometimes, there is a possibility that a woman can have an allergic response towards the dye. In such a situation, you must keep an eye on the following symptoms: 

  • Slight vaginal bleeding-: After HSG, you will have light vaginal discharge or bleeding for a few days. 
  • No tampons-After the HSG procedure, do not use tampons for at least 48 hours. Sanitary pads help prevent infection and will be a comfortable option. 
  • According to some doctors, vaginal intercourse and douching should also be avoided after HSG for 48 hours. 
  • Abdominal cramps or pain- Having cramps for a few hours after HSG is fine, and the pain will go away after some time. 

Visit an IVF Specialist if you have the following symptoms: 

  • Heavy Bleeding-Seek medical guidance if you have heavy bleeding or if it lasts longer than a couple of days.
  • High Fever– If you have a fever that is accompanied by constant pain, then this indicates an early infection. This situation warrants urgent medical attention. 
  • Foul-smelling Vaginal discharge-: Vaginal discharge after HSG is normal, but if your discharge has a foul smell, please pay a visit to the doctor. 
  • Frequent Vomiting– If you are constantly vomiting, connect with your doctor without delay. 
  • Severe Abdominal Cramps– Consult with your doctor if the pain becomes unbearable or doesn’t go away on its own after some time. 
  • Fainting– If you are fainting every time you try to get up, it’s best to visit a doctor. 

Alternatives to HSG 

Sonohysterograms, laparoscopy, and hysteroscopy are the alternate procedures for HSG that help gather similar results. However, the HSG test is preferred more as sonohysterograms can’t help determine if the fallopian tubes are blocked. 

Saline contrast ultrasound can also be performed to gather information about the uterus. 

The Results of the HSG Test

Based on your HSG test results, the doctor may advise you to take some other tests and develop a treatment plan for you. 

If scar tissue is present in or around the fallopian tube, the fertility specialist can perform surgery to remove it. 

Depending on the extent and type of blockage in the fallopian tubes, surgery can be performed to open them and improve the chances of fertilisation. 

The doctor will advise a suitable Assisted Reproductive Technology treatment like IVF after thoroughly analysing the test reports. 

Does HSG Increase the Chances of Conception? 

The HSG test is mainly recommended for diagnostic purposes and perform surgery to improve fertility. However, some studies highlight a slight improvement in fertility after HSG. 

Final Word

Conceiving has become challenging for millions of women. However, medical advancements have led to tests like HSG that can help get to the root cause of infertility and assist with diagnosis. These types of improvements help design surgical operations and fertility treatments that best suit the medical condition of the couple. For more information about this test, visit a trusted medical expert. 

If you are looking for medical expertise in Srinagar to help develop the best fertility treatment option for you, then do visit us at Imprimis IVF, Srinagar. A fertility centre where shattered dreams of pregnancy are turned into positive pregnancy test results. Hope to see you soon at Imprimis!