What is a hysterosalpingogram?

A hysterosalpingogram is an x-ray of the uterine cavity and fallopian tubes after injection of a radiopaque substance (x-ray die). It is used to visualize any scarring, polyps, adhesions, or blockages within your fallopian tubes or uterus. It also reveals the shape and size of your uterus and fallopian tubes. The test is used primarily to diagnose fertility problems; however, sometimes the procedure itself will loosen up any tissue or debris that may be causing an obstruction or blockage.

How is a hysterosalpingogram performed?

A hysterosalpingogram is a simple outpatient procedure that can usually be done in 15-20 minutes. Some women may complain of discomfort and mild cramping from the procedure. It may be helpful to take an over the counter medication such as tylenol or ibuprofen 30 - 60 minutes before the procedure. The hysterosalpingogram is performed by inserting a speculum into the vagina to visualize the cervix (as is done in a pap smear or pelvic exam). The die used to visualize the uterus and fallopian tubes is instilled up into your cervix and into the uterine cavity. This test should be performed between between 7 and 9 days after the start of your menstrual cycle. It should be performed before ovulation to avoid harming any possible early pregnancy. It is also best to perform the test after menses and before ovulation because of hormonal changes that effect the lining of your uterus. With the rich, thick uterine lining that occurs after ovulation, it is possible to show inaccurate results.

What can a hysterosalpingogram tell me about my fertility?

In order to become pregnant at least one of your fallopian tubes needs to be open and not obstructed. As the die flows through your uterine cavity and up through your fallopian tubes any obstructions or blockages can be visualized. The hysterosalpingogram can also reveal any defects in the structure or shape of your uterus. An abnormally shaped uterus can effect your chances of conception and successful pregnancy. A hysterosalpingogram can also reveal polyps, scarring, adhesions, and other defects or abnormalities of the uterus and fallopian tubes that may effect your fertility.

After the hysterosalpingogram

Your doctor may prescribe a prophylactic antibiotic to be given after the hysterosalpingogram to avoid any chance of infection. Mild spotting, cramping, and bleeding may occur after the procedure. Wearing a sanitary napkin and continuing the use of ibuprofen or tylenol may be helpful. If you have heavy bleeding, fever, severe pain, or any unusual symptoms after the procedure, consult your physician.