Annie Collum, BSN, RN is the RIA Senior Manager, Physician Liaison in Denver, Colorado
What is a hysterosalpingogram?
A hysterosalpingogram (HSG) is an exam that looks at the condition of the uterus, fallopian tubes and abdominal area around them. It is primarily used to determine reasons why a woman may have difficulty becoming pregnant or sustaining a pregnancy. It is also done for women who have had tubal ligation or permanent contraceptive devices implanted into the fallopian tubes to verify the effectiveness of these procedures.
Hysterosalpingograms use a fluoroscope to take images of the reproductive organs. A fluoroscope uses x-ray technology but takes continuous images rather than a single image like a traditional x-ray. A contrast material is used to enhance the images and make any abnormalities more visible.
During a hysterosalpingogram, a small tube called a catheter is placed into the cervix through the vagina. The contrast material is injected through the catheter into the uterus. The catheter has a small balloon on the tip which will be inflated to create a seal and keep the contrast from flowing back through the cervix. Since the uterus and the fallopian tubes are connected, the contrast will flow through the uterus and into the fallopian tubes. If the fallopian tubes are not completely blocked, the contrast may then flow from the fallopian tubes into the abdominal area.
The fluoroscope images can show an abnormality of the uterus or a blockage of the fallopian tubes. A blockage could prevent the egg from ever becoming fertilized. Occasionally, an HSG can have a therapeutic effect. The contrast may flush unseen blockages and enable conception without additional medical procedures; however, that should not be relied upon. Abnormalities in the uterus could prevent fertilization or implantation of an egg or could be the cause of miscarriages.
PERMANENT CONTRACEPTIVE DEVICE PLACEMENT
An HSG is needed three months after the placement of a permanent contraceptive device (i.e. Essure or Adiana). This ensures that the micro-inserts are properly in place and that the fallopian tubes are completely blocked.
WHEN SHOULD AN HSG BE DONE?
This procedure should be done within the first 10 days of your menstrual cycle, but after blood flow has stopped. This is usually between days 7 and 10. This is to ensure you are not pregnant and to avoid using x-rays, which emit radiation, during an early pregnancy. If you are not having menstrual periods, a pregnancy test may be required. More information can be found on our page – https://www.invisionsallyjobe.com/services/hysterosalpingogram-hsg.