Monday, January 24, 2022

Hysterosalpingograpy (HSG Or Tube Test)


HSG is an X ray test which is done to see the outline of the shape of the uterus and to check if the fallopian tubes are blocked or open.

It is a minor procedure in which a special dye is injected that fills the uterus and then spills through the open fallopian tubes.

When Should this test be done

- As a part of workup for infertility.

- Usually recommended when a couple has been trying for more than a year with no success and when other basic tests have already been done.

- It is done after the periods ends but before the expected ovulation usually on cycle day 8 or 9.


- The procedure takes around 15-20 minutes and is usually done in x ray department. 

- The woman is made to lie on a bed that is positioned so that a x ray imager is above, that can take pictures during the procedure. 

- The gynecologist will do an internal examination and then places a speculum in the vagina.

- The cervix is visualized then cleaned and then a cannula like devise is placed into the opening of the cervix.

- Then through this cannula a liquid dye that contains iodine is slowly injected to fill up the uterus.

- This dye can be seen on the Xray as a white image. 

What Abnormalities can be detected on HSG

- Abnormalities like polyps or fibroids inside the uterine cavity can be seen.

- The shape of the uterus is outlined and any abnormal shape can be detected.

- The length of the fallopian tubes and if they are open by the spill of the liquid dye confirms the patency. 

Is it Painful?

- The procedure may cause mild to moderate periods like cramps for around 5-10 minutes. 

- Some women may experience more pain and some may complain of only a mild discomfort. 

- Some may experience on and off cramps for 1-2 days after the procedure. 

- Pain killers like ibuoprofen before the procedure can help reduce the pain.

Chances to Conceive after the procedure.

Although HSG is only a diagnostic procedure, it is observed that after a normal HSG test where the tubes are open there is a slight increased chance to conceive for the next 3 months. 

Risks And Complications

- Generally a very safe procedure.

- Infection is one of the most common complications and usually occurs if the procedure is done when there is already a pelvic infection.

- Some women may faint and this may happen if they are stressed about the procedure or may have a low threshold for pain.

- Radiation exposure: since the images are taken by x ray there is radiation exposure nut the risk of any damage is usually very low. 

- Iodine allergy: very rarely if allergic to iodine contrast dye allergic reaction may happen.

- Spotting or very light bleeding may happen for 1-2 days after the procedure. If any heavy bleeding should inform doctor immediately. 

What to do If Tubes are Blocked

- If only one tube is blocked conceiving is still possible but the chances are reduced. 

- If both tubes are blocked either you need to go for IVF procedure to conceive or a laparoscopy is done in which tubes are washed and an attempt is done to open them. 

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