In fertility workups, a closer look at the uterus and fallopian tubes may be required. A hysterosalpingogram (HSG) is an X-ray that can visualize the uterus (hystero) and fallopian tubes (salpingo). It offers an optimal vantage point by combining X-ray technology with a dye that can be introduced into a woman’s reproductive region.

Why It Is Done

The HSG tests the patency of the fallopian tubes (if they are open). When combined with ultrasound (referred to as a hysterosalpingosonogram or ultrasound hysterosalpingogram), this test can also determine if there are any fibroids or polyps present. It also evaluates the size, shape and structure of the uterine cavity.

How It Is Done

The test is usually done in a radiology facility and takes a few minutes. A special oil- or water-based dye is injected through the cervix and into the uterus and fallopian tubes. X-ray fluoroscopic equipment is used to monitor the movement of the liquid as it progresses from the uterus to the tubes. This helps to show the shape and structure of the uterine cavity and also if the fallopian tubes are open or blocked. If the patient is allergic to iodine, the test should be adapted to use a contrast medium that will be better tolerated. This reduces the chance of an allergic reaction. Several X-ray films are taken; many times the normal result is called a ‘fill and spill’ – the dye filled the cavity and tubes and spilled out the end of the fallopian tubes indicating they are open.


Risks that are associated with the procedure include:

  • Cramping
  • Allergic reaction to the dye
  • Bleeding
  • Lightheadedness
  • Infection

One potential complication following an HSG is infection. Many healthcare providers will prescribe antibiotics to help ward off infection from the procedure. Also, some will recommend that you take ibuprofen prior to the procedure to minimize the discomfort. Evidence shows that HSG increases fertility in some instances, primarily if HSG oil is used rather than the water solution. HSG may improve the tubal function by opening blockage caused by adhesions or plugs.

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