Definition A hysterosalpingogram (HSG) is an imaging study, or x-ray test. It is used to view the inside of a woman's uterus, or womb, and fallopian tubes.
Who is a candidate for the test? A hysterosalpingogram is usually done to try to determine why a woman is infertile, or unable to get pregnant. In some cases, this test may be used:
How is the test performed? A hysterosalpingogram is usually done in an x-ray department. The woman is first asked to change into a hospital gown and lie on a table. A plain x-ray picture of the pelvic area is taken. The woman is then asked to lie in the position normally used for a pelvic examination. The doctor performing the test will then insert a speculum into the vagina. A speculum is a tool that allows the doctor to see the cervix, which is the opening to the womb.
A metal clamp is gently attached to the cervix so that a thin plastic tube can be inserted into the womb. This tube is used to inject contrast material into the womb and tubes. Contrast material is used because it can be easily seen inside the body when an x-ray picture is taken. Though some women get cramps while the contrast material is injected, pain is unusual. After the contrast material is injected into the womb, pictures are taken of the womb and fallopian tubes.
Once pictures have been taken, the instruments are removed from the vagina. The contrast material is then allowed to drain out of the vagina. A final x-ray picture is taken, which ends the test. The woman is then free to get dressed and go home.
What is involved in preparation for the test? Instructions for the hysterosalpingogram will be given by the doctor and the x-ray department staff. Any jewellery or metal objects that may interfere with the examination must be removed. A woman having an HSG should alert the doctor if there is a possibility of pregnancy.
An HSG is scheduled in advance so that a woman is not having her period on the day of the test. The contrast material usually contains iodine, so women who are allergic to iodine should tell the staff. Other preparations may be needed in some cases. The doctor or x-ray department will discuss these before the test if needed.
What do the test results mean? A normal hysterosalpingogram occurs when the womb and tubes appear normal and the contrast material moves freely through them. Common problems that may be seen with this test include:
physical defects inside the womb or tubes that have been present since birth, also called congenital defects
blockage in the fallopian tubes
growths or tumours inside the womb or tubes, such as a scar or tumour
inflammation in the womb or tubes
abnormalities of the lining of the uterus or tubes, such as scarring
Other conditions may also be detected. The doctor will discuss the results of the test once they are available.
Author: James Compton, MD Reviewer: eknowhow Medical Review Panel Editor: Dr John Hearne Last Updated: 6/06/2005 Contributors Potential conflict of interest information for reviewers available on request
