What is an HSG?
A hysterosalpingogram is a minimally invasive procedure which uses a dye (contrast) and radiation to visualise the uterine cavity and fallopian tubes, to assess for uterine abnormalities and tubal obstruction. Your doctor will request for this procedure to be performed with either water-soluble contrast (Visipaque) or oil-soluble contrast (Lipiodol).
HSG can help to diagnose endometrial polyps, fibroids and scarring, and is part of an assessment for fertility problems.
If you need an HSG, here’s everything you need to know.
Before your procedure
The timing of your appointment is important. It needs to be after your period has finished, but before you ovulate – between days 7 and 12 of your cycle. Therefore, you should phone on the first day of your period to book an appointment (approximately a week in advance). When you make your appointment, the booking team will give you a rundown of everything you need to know on the day of the scan.
You may be given preventative antibiotics to take the day before, the day of, and the day after the HSG. Over-the-counter pain medication taken 30 to 60 minutes before your HSG can help reduce pain, but please check with us before taking this. Unless you’ve been asked not to, you should continue eating and drinking normally and take all your usual medications.
Please also remember to bring your completed doctors referral form with you, if this has not already been sent to us. This will ensure the branch reception has all the necessary information required so our expert team can provide you with the best care possible.
On the day of your procedure
When you arrive, please check in with reception. We’ll make sure your details are correct, and give you any forms to fill out. You’ll change into a gown, then lie on a comfortable table.
The radiologist will use a speculum to visualise the cervix, and then a fine catheter is placed in the cervix. The speculum is removed when the catheter is satisfactorily positioned. The dye is then very gradually introduced into the uterine cavity and passes through both fallopian tubes, unless they are blocked. The volume of dye used is usually between 5mL and 10mL (i.e. less than two teaspoons). Some patients experience mild discomfort, similar to period pain, while the balloon is inflated or while the dye is injected, but this is usually well tolerated.
As the uterus and fallopian tubes fill with dye, the x-ray images are taken.
An internal or transvaginal ultrasound of the uterus is also performed while the dye is in the uterine cavity, improving assessment for uterine adhesions or endometrial polyps. Ovarian assessment is also performed.
After your procedure
The results of your procedure will be discussed with you before you leave and you will have the opportunity to ask questions.
Most women are able to resume all normal activities immediately following the procedure.
You may experience bleeding or light spotting. If you have pain in your lower abdomen, heavy bleeding, discharge or a high temperature, contact your doctor.
Who can't have an HSG?
An HSG procedure must be performed between days 7 and 12 of your cycle. This means, that outside of these days (i.e. during your period or ovulation) you are unable to be tested.