HSG Explained: What to Expect During Your Hysterosalpingogram

A hysterosalpingogram, or HSG, is a common procedure that evaluates uterine and fallopian tube health. HSGs are used by fertility specialists to identify potential barriers to conception and create personalized treatment plans to help you achieve your family-building goals. They provide valuable information by identifying blocked fallopian tubes, uterine abnormalities, and infections or scar tissue.  

In this blog, we’ll explain how HSGs are performed, what to expect after, the risks involved, and why a fertility specialist is recommended for this procedure.  

How is the HSG Procedure Done? 

An HSG is a relatively quick and straightforward procedure, though it does require some preparation. Here’s a breakdown of what you can expect: 

1. Timing of the Procedure: The HSG is typically done during the first half of the menstrual cycle, usually between day 7 and day 10. This timing helps ensure that there is no pregnancy and that the endometrial lining is thin, providing the best view of the uterus and fallopian tubes. 

2. Pre-Procedural Preparation: Before the procedure, you may be asked to take an over-the-counter pain reliever, such as ibuprofen, to help reduce any cramping or discomfort. Some doctors may also recommend an antibiotic before the procedure to prevent any risk of infection. 

3. The Procedure: The procedure itself is performed in a doctor’s office or a radiology clinic and typically takes around 2-3 minutes. You will lie down on an examination table, and a speculum, like the one used during a pap smear, is inserted into the vagina to access the cervix. 

4. Contrast Dye Injection: A special dye is injected into the uterus through the cervix using a thin tube, called a cannula. This dye is visible on X-rays and allows the doctor to clearly see the shape of the uterus and whether the fallopian tubes are open. X-ray images are taken as the dye flows through the uterus and fallopian tubes. 

5. Post-Procedure: After the procedure, you may experience some mild cramping, spotting, or discomfort, but these symptoms typically resolve within a few hours. Most women can resume their normal activities after the procedure, though it's a good idea to rest for a bit if you're feeling uncomfortable. 

What to Expect During and After the HSG Procedure 

While the HSG is relatively quick, it can be slightly uncomfortable. Some women report feeling cramping or pressure during the injection of the dye. However, these sensations usually only last a few minutes. The pain is typically mild and can be managed with over-the-counter pain relief. 

After the procedure, you may experience light bleeding or spotting, which is normal. Some women also experience cramping or discomfort in the lower abdomen for a day or two. It’s important to contact your doctor if you experience heavy bleeding, severe pain, fever, or unusual symptoms, as these could indicate an infection. 

Risks and Considerations 

HSG is a generally safe procedure, but, like any medical test, there are some risks involved: 

1. Infection: While rare, there’s a small risk of infection due to the introduction of instruments or dye into the reproductive system. 

2. Discomfort: As mentioned, cramping and spotting can occur, but these are usually mild and temporary. 

3. Allergic Reaction: There’s also a small risk of an allergic reaction to the contrast dye, though this is very uncommon. Inform your provider of any known allergies, especially if you are allergic to shellfish.  

Why should you have an HSG done by a fertility specialist?  

While HSG is a relatively simple procedure, the expertise and technique involved can significantly impact the quality of the results. It is recommended to have your HSG performed by a fertility specialist: 

1. Minimize Pain and Discomfort: The technique used during the procedure can impact the amount of pain and discomfort you may experience. Proper technique is crucial for accurate results as well as your overall comfort levels.  

2. Interpretation of Results: Fertility specialists are trained to not only perform HSGs but also interpret the results. The fertility specialists at CRM have years of experience identifying issues that may otherwise go unnoticed, such as small blockages or uterine abnormalities. 

3. Personalized Care: Fertility specialists can offer immediate guidance if any abnormalities are identified.  

4. Holistic Fertility Support: While HSGs provide great insights into uterine or tubal factors that may be affecting your fertility, they do not provide all the information to make an informed treatment plan. Other tests such as blood work and ultrasounds are needed to gain a complete understanding.  

At the Center for Reproductive Medicine, our fertility specialists use multiple diagnostic tests to gain a comprehensive understanding of your reproductive health before creating your personalized treatment plan to address your unique needs. 

Conclusion 

HSG (hysterosalpingogram) provides valuable insights for individuals and couples struggling with infertility by evaluating the health of the uterus and fallopian tubes. This test is an essential step in identifying potential barriers to conception and assisting fertility doctors in creating personalized treatment plans. 

Our fertility specialists provide expert interpretation of results and individualized care plans ensuring you get a comprehensive understanding of your reproductive health. If you are ready to take the first step, schedule a consultation at our Winter Park or Celebration location.