An important test for the investigation of female infertility, hysterosalpingography (HSG) is an X-ray procedure that is used to view the inside of the uterus and fallopian tubes. It also can show if the inside of the uterus is of a normal size and shape.
When it is recommended
In case that woman does not get pregnant while her partner’s sperm is normal
In the context of control before insemination or in vitro fertilization
After salpingitis, gonorrhoeae or chlamydia
In case of recurrent miscarriages
To check for anatomical abnormalities of the uterus, or the presence of an endometrial septum
For further investigation of pathological findings on ultrasound, such as endometrial polyps, fibroids, adhesions.
What is the right time to take place?
The right time for a woman to have a fallopian tube is in the first phase of her cycle, in the first 10 days after the period and, ideally, the period from the 9th to the 11th day of her cycle (before ovulation).
The preparation
Have not had sexual intercourse from the first day of the period until the day of the examination
How the test is done
The examination of hysterosalpingography uses almost the same gynecological tools as the PAP test. The woman lies on the radiological table under the X-ray machine and the special vaginal dilator is placed at the opening of the vagina. Once the gynecologist has cleaned and properly prepared the cervix, he places a thin and soft tube (catheter) in the cervix, channeling with its help the contrast substance that will “fill” the cavities of the uterus and the fallopian tubes. In the short period of time (5-10 minutes) during which the cavities are “filled” with the contrast material, targeted x-rays are taken. The role of the iodinated water-soluble contrast medium is to accurately capture these areas (uterus and fallopian tubes) on X-rays. The examination is completed with the x-ray of the woman in an upright position, in order to determine if the contrast material has passed through the entire peritoneal cavity and there is no fluid retention in the fallopian tubes (as for example in case of adhesions).
*The diagnosis of the test results is immediate. A prerequisite for the completion of the examination process is the reception of prophylactic antibiotic therapy in order to avoid a possible intrauterine infection.
What to watch out for
Hysterosalpingography should not be performed in women with inflammatory pelvic disease or unexplained vaginal bleeding
Your doctor should be aware of any allergies to any of the medicines
On the day of the test you can eat and drink normally
Ideally, 2-3 days before the test, avoid anything that may cause discomfort in the abdomen. The more relaxed you are, the easier the test is
Sometimes, immediately after hysterosalpingography or even 24-48 hours later, a minimal amount of blood may appear, which is completely normal and expected. However, in case the bleeding or pain is intense, consult your gynecologist immediately.
The most common concern of women who are called to the test is the fear of discomfort or pain during and after. In fact, with proper preparation the test is well tolerated and most women experience during it something similar or less than mild cramps and period pains. Women who present with pathological findings, such as adhesions in the intrauterine cavity and / or blocked or narrow-passage tubes, usually experience greater pain intensity. After the end of the examination, the woman can return to her normal activities or work, if she feels well and wants to.
The additional benefits of the test
In addition to being diagnostic, hysterosalpingography also has therapeutic benefits. As the contrast fluid penetrates the uterine cavity and the fallopian tubes and since there are no serious pathological findings, it acts as an obstructive material by cleaning and opening the fallopian tubes, with any micro-adhesions and micro-occlusions being dissolved and disintegrated respectively. A fact that will contribute to achieving pregnancy with natural conception, if not the same, in subsequent cycles.