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This leaflet informs you of the procedure known as HSG. It is not to replace informed discussions between you and your doctor. Ensure that you have sufficient explanations of what is involved before you consent.
What is Hysterosalpingogram (HSG)?
An HSG is a special radiological examination which looks at the inside of your womb (uterus) and tests the patency (openness) of both fallopian tubes leading to the ovaries. If one or both of these tubes are blocked or damaged, then the chances of becoming pregnant are much reduced. The exam results will help your doctor decide the best treatment options to advise you.
When can the test be performed?
HSG is only carried out within the first 10 days of your menstrual cycle.
You must refrain from sexual intercourse from the day your period starts until after the HSG test to ensure there is absolutely no possibility of you being pregnant.
If for any reason you do not have periods, or have a long cycle with infrequent period, or if you are unsure you may need to speak with your Gynaecologists to discuss the best timing of the procedure.
What does HSG involve?
When you arrive at the X-ray Department a nurse or a radiographer will ask you to change into a hospital gown. You will be taken into the X-ray room where a practitioner will explain the HCG procedure in full and answer queries you may have before the procedure.
You will be asked to lie on the X-ray table, generally flat on your back. The practitioner will keep everything sterile as possible and will wear sterile gloves. Initially the examination is like a smear test. Your vagina will be cleaned with an antiseptic, then a speculum (a duckbill shaped device used to see inside hollow parts of the body) will be used to open vaginal wall to better visualize the cervix. Once the cervix is seen it will be swabbed with an antiseptic. Then a small plastic flexible tube (catheter) will be positioned through the opening of the cervix until the tip is inside the uterine cavity. Then, the contrast (a colourless liquid that shows up black on X-rays) will be injected into the tube to highlight the uterus and fallopian tubes. A couple of X-rays will be taken.
You should let us know if you have any allergies or have had a reaction to any contrast medium injections before.
Will it hurt?
The procedure although simple, may cause some discomfort, and you may experience some cramping pains when the contrast is injected. (This usually passes as soon as the catheter is removed but if you wish, you may take any pain relief that you usually take when you have period pains like paracetamol or ibuprofen). At least 1 hour before your appointment.
How long will it take?
Every patient’s situation is different, and it is not always easy to predict how complex or how straightforward the procedure will be. It may be up to 20 minutes, or very occasionally it may take longer. As a guide, expect to be in the X-ray department for about an hour altogether.
What happens after the procedure?
You will be allowed home following the procedure and can return to work depending upon how you feel.
Following the test there may be some slight spotting from where the catheter has been through the cervix. And the fluid (contrast dye) will trickle out over the next 24 hours.
You will be given a sanitary pad (if you haven’t brought your own) and shown to the rest room where you can get dressed and freshen up. Please do not use tampons.
You may also experience some period type pain although this should respond to any pain relief that you usually take.
You should have no significant pain or bleeding following the test, but should this happen later, you will need to contact your GP.
Are there any risks or complication?
HSG is a very safe procedure but there are some risks and complications that can arise:
Very rarely, infection can be introduced into the inside of the pelvis. If, however, you develop a discharge, you become unwell with a temperature or have symptoms such as pain, fever or chills please see your GP and say that you recently have this procedure.
This can be generally treated satisfactorily with antibiotics.
Risk of the procedure
Allergic reaction: This is extremely rare, but it is possible that you may have an allergic reaction to the contrast, this may include swelling of the skin, hives, nausea, fainting or shortness of breath. That is why it is it very important that you let the staff know about your allergies especially to iodine and contrast.
Risk to ionizing radiation: As this procedure involves x-rays, there are the usual slight risks associated with ionizing radiation. The amount of radiation we use is very small, (the equivalent of a chest X-ray) X-rays pose a risk in pregnancy during the early stages of development; we take all precautions to ensure you are not pregnant at the time of the test.
Risk of fainting: Occasionally some patients feel faint after the test. Should you feel faint we will ask you to wait until you feel better.
When can I try for a pregnancy?
You can start trying to get pregnant as soon as you want to or as advised by your doctor.
Are there any alternatives?
If you are unable to tolerate this procedure your referring doctor will be informed, and he/she can decide if an alternative examination is appropriate for you.
When will I know the results?
The Radiologist will prepare a report of your examination, which will be sent to the doctor who referred you to us. The final result will be sent to your consultant and will be available at your next clinic appointment.
Who do I contact for more information?
If you have any further queries regarding your procedure, please feel free to ask questions on the day of your examination or speak to your referring clinician.