Fertility Treatments


A Hysterosalpingogram, or HSG, is a diagnostic test performed by a doctor to evaluate your fallopian tubes or the insides of your uterine wall.


If you are trying to conceive, all the organs and tissues in your reproductive system must be working in perfect tandem. You must be ovulating, a process in your ovaries that happens every month during which they produce an egg. Your fallopian tubes must be open for this egg to be fertilised with the sperm, and the uterus must be in perfect shape for embryo creation. 

If even one of these parts of the pregnancy process does not go the way it should, you may encounter an issue getting pregnant or may not be able to conceive at all.

Blockage in the fallopian tubes is considered a significant problem because it leads to two massive issues. One of these is that your egg won’t be able to reach the sperm for fertilisation, and the other one is that the fertilised embryos won’t reach the uterus for implantation. 

There may be several reasons why your fallopian tubes are blocked close. But the doctor will perform a test called hysterosalpingogram or HSG to diagnose the root cause of your condition.

What Is A Hysterosalpingogram?

A diagnostic test performed by the doctor to assess your fallopian tubes or the insides of your uterine wall is referred to as a hysterosalpingogram or HSG. It is a minor procedure to collect information about the contour and shape of the uterus or endometrial cavity. It can also help record and register the presence of fibroids or leiomyomata, scarring or endometrial polyps. Furthermore, this procedure can also help the doctor determine if your fallopian tubes are open or blocked. 

One of the factors that may decrease the likelihood of pregnancy in women is a blockage in your fallopian tubes. This blockage may prevent the sperm from reaching the eggs. Therefore, during the HSG or hysterosalpingogram, your doctor may use a special dye and X-rays to detect any polyps, scar tissues, fibroids, etc., that may be causing the blockage, prevent fertilisation between sperm and eggs, and the fertilised embryos from reaching the uterus for implantation. 

Another test that may be used to detect the abnormalities in your uterus is a sonohysterogram, which uses a unique solution and ultrasound. But this test cannot be used for the detection of blockages in your fallopian tubes. Hysterosalpingogram is a test routinely performed during your infertility diagnosis. 

A few other things that can be detected through HSG or hysterosalpingogram are as follows:

  • To examine the fallopian tubes to detect any abnormalities or defects, assess if the blockage is partial or complete, or see if there is pelvic scar tissue in your abdominal cavity near the fallopian tubes. 
  • Evaluation of the uterine cavity to detect the presence of polyps, uterine scar tissue, congenital uterine anomalies or fibroid tumours. 


Suppose you have not conceived a child despite repeatedly trying to get pregnant through natural sexual intercourse. In that case, the doctor may suggest a hysterosalpingogram or HSG for examining blockage in your fallopian tubes.

How Is HSG Done?

Usually, it will take the doctor only around 5 minutes to perform the hysterosalpingogram procedure. HSG tends to be performed in the radiology department. You will have enough time to fill out a registration form in person at the facility to provide information about your allergies to any prescribed medications, etc. 

Here are steps to provide you information about how this test is going to proceed:

  • The doctor will first ask you to lie down on a table with her feet up in the stirrups in the frog-leg position. 
  • After that, they will use a speculum by placing it in the vagina and envision the cervix. 
  • The doctor will either place a thin, soft catheter through the cervical opening in your uterine cavity or use tenaculum, which will be placed on the cervix, after which a narrow metal cannula will be inserted through your cervical opening. 
  • Then, they will slowly inject contrast through the catheter or cannula into your uterine cavity. After that, the doctor will take an X-ray picture of the cavity. Additional contrast will be inserted into the tubes so that they spill into your abdominal cavity. After this spill occurs, more X-ray pictures will be taken. 
  • After the fillup of both tubes, you will be asked to roll over to one side and obtain an oblique X-ray image, which can help further describe your anatomy. That concludes the hysterosalpingogram procedure. 
  • After completing this procedure, the instruments and tubes will be removed from your vagina. 
  • There may be some cramps due to the contrast injections. So you may be asked to remain on the table. 
  • Since the test results of X-rays are available immediately, the doctor will discuss them with you right after the procedure. 


Several studies have shown a slight increase in the pregnancy rates in the first few months after the patient has had an HSG or hysterosalpingogram. That may be attributed to the flushing of the tubes during this procedure. In addition, it can help clear out some debris and open a minor blockage that may be preventing you from getting pregnant. 

After having a hysterosalpingogram, there most probably will be some sticky vaginal discharge draining out of your uterus. It may also be stained with blood. You can use a sanitary pad to contain the discharge. But don’t make the mistake of using a tampon for it. 

A few symptoms you may experience after the completion of the test are as follows:

  • Cramps
  • Minor vaginal bleeding
  • Feeling of being dizzy and chances of regurgitation. 


But the doctor will tell you all about the probability of these symptoms before starting the procedure during the consultation.

Risks And Complications

Although it is considered safe, like any other medical procedure, there are some risks associated with hysterosalpingogram. But the chances of encountering these complications is less than 1%. 

The potential complications are as follows:

  • Fainting: Although rarely, you may get light-headed during or just after the procedure.
  • Allergy to iodine: In case of an allergy to iodine, you may experience itching, rash, swelling, etc., due to iodine-based contrast. In that case, you may want to contact your doctor immediately. You should mention if you are allergic to iodine in the form before the procedure. If you are, the doctor will use a contract not based on iodine. 
  • Infection: One of the most common complications associated with a hysterosalpingogram is pelvic infection. The chances of this infection will be higher if you have previously been infected with a tubal infection like chlamydia. This infection may inflict damage to your fallopian tube. So get in touch with the doctor if you experience pain. 
  • Spotting: Spotting tends to be there for 1 or 2 days after the procedure. But if you experience profuse bleeding, visit your doctor.
  • Radiation exposure: You are less likely to have radiation issues with this technique than a bowel or kidney study. 


Although they are quite rare, if you experience any of these complications, get in touch with your doctor immediately.


HSG or hysterosalpingogram is a diagnostic procedure performed to evaluate your fallopian tubes or the insides of your uterine wall. The doctors often use this procedure to see if your fallopian tubes are partially or completely blocked, as it may be causing issues with your pregnancy. 

Although it is quite safe, there may be some complications like any other medical procedure. These complications are fainting, profuse vaginal bleeding, malodorous smelling vaginal discharge, fever, vomiting, abdominal cramps, spotting, pelvic infection, radiation burns, etc. 

If you have any other queries regarding hysterosalpingograms, get in touch with the experts at Siya Health.

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Dr. Dipesh Sorathiya

M.S. (Obs & Gyn)
DIP. in Gynec Endoscopy (CICE)

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