What is a hysterosalpingogram?
A hysterosalpingogram is an X-ray exam of the uterus and fallopian tubes. It uses fluoroscopy, which creates a moving picture rather than a single still image, to track the flow of contrast material in the uterus so the radiologist can clearly see the areas of interest.
Why is it ordered?
Your doctor may order a hysterosalpingogram to investigate the cause of fertility problems, such as trouble conceiving or multiple miscarriages. The test will show whether infertility is caused by blockage of the fallopian tubes. If no blockage exists, then the contrast dye will flow through the uterus and fallopian tubes and dissipate into the abdominal cavity around the ovaries. If the fallopian tubes are blocked, then the flow of dye will be interrupted, showing where the blockage exists. Additionally, a hysterosalpingogram can help to identify uterine abnormalities such as adhesions, fibroid tumors, and other types of uterine masses.
Hysterosalpingography may also be ordered following tubal surgery. After tubal ligation, the test is used to verify that the fallopian tubes are properly closed. Following a reversal of this procedure, it can help to assess whether the tubes have been successfully reopened.
What should I expect?
The procedure is fairly simple and quick. It should be scheduled for 6–12 days following the first day of your period, after you’re no longer bleeding. Plan to wear a loose-fitting 2-piece outfit the day of the procedure for your comfort and convenience. Because cramping is common, you may wish to take an over-the-counter pain medication, such as ibuprofen, about 30 minutes before the exam.
When you arrive at the clinic, the radiologic technologist will take a thorough medical history. Then, you’ll be given a gown or blanket and asked to empty your bladder and disrobe from the waist down. You will lie face up on the exam table, and the radiologist will insert a speculum to access the cervix, which will be cleansed with an antiseptic soap to prevent infection. The radiologist will insert a small, flexible catheter through the cervix into the uterus to introduce the contrast dye. Several pictures will be taken, and you may be asked to shift position during this time to get the best possible images. After the images are taken, the catheter is removed, and the exam is complete.
You may experience cramping and/or spotting for 24–48 hours following the procedure. You may use over-the-counter medication to ease the cramping. For spotting, use a pad rather than a tampon to minimize the risk of infection.
Complications from hysterosalpingography are rare but can include infection, reactions to contrast dye, and uterine injury. Be sure to tell your doctor and the technologist if you have ever had an adverse reaction to imaging contrast material, and alert your doctor as soon as possible if you develop symptoms of infection, such as fever, intense pain, foul-smelling vaginal discharge, heavy bleeding, vomiting, or fainting.
Iowa Radiology provides a wide range of women’s imaging services, including hysterosalpingography, sonohysterography, 3-D mammography, obstetric, pelvic, transvaginal, and breast ultrasound, breast MRI, and imaging-guided breast biopsy. We pride ourselves on putting patients first and will do all we can to make you as comfortable as possible during your visit. Feel free to contact our office with questions about a procedure at our clinics.
"Hysterosalpingography: Purposes, Procedure, and Risks." Healthline.com. Healthline Media, 30 Nov 2015. Accessed 14 Dec 2017.
"Hysterosalpingography (Uterosalpingography)." Radiologyinfo.org. Radiological Society of North America, 8 June 2016. Accessed 14 Dec 2017.
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