Hysterosalpingogram (HSG)

Hysterosalpingogram (HSG)

Our team is committed to offering complete, and extensive, fertility care. We are excited to announce our Gynecoradiology Suite, in which we offer Hysterosalpingogram (HSG). Dr. Ghadir is licensed to perform the HSG procedures and ensures the best possible experience and immediate diagnostic results upon completion of the examination.

What is a Hysterosalpingogram?

A Hysterosalpingogram, or HSG, is a fluoroscopic x-ray procedure in which we can evaluate the patency, or openness, or the Fallopian tubes and the shape of one’s uterine cavity. Below are a few frequently asked questions about HSG procedures:

How are HSG Procedures Helpful in an Infertility Diagnosis?

One of the primary causes of infertility is blocked Fallopian tubes, which is exactly what HSG’s are exceptional at detecting. This makes HSG a crucial component in the initial infertility evaluation. There are other indications that an HSG may be necessary, including recurring miscarriages, irregular vaginal bleeding, or possible uterine abnormalities. Many times our team will perform an HSG procedure before a tubal ligation reversal surgery, in order to establish residual tubal length and also to check for any tubal abnormality.

Why Should my HSG be Performed by a Fertility Specialist?

While your primary OB/GYN may offer HSG testing, fertility specialists, like those on our team, read and interpret HSG test data on a regular basis. Familiarity with these procedures is important and can help ensure most accurate infertility diagnosis

How is an HSG performed?

HSG is a simple 30 minute, outpatient procedure, which is done in the follicular period of the menstrual cycle, which occurs before ovulation and after menstruation has finished. HSG are done by inserting a small catheter into the cervix and uterus to inject a radio-opaque dye that allows specialists to view the outline of the Fallopian tubes in an x-ray. As the dye travels throughout the uterine cavity, the HSG provides a sequence of fluoroscopic images revealing abnormalities of the uterine cavity or Fallopian tubes.

What is the difference between a Hysterosalpingogram (HSG), a Hysteroscopy, and a Sonohysterogram?

A Hysteroscopy uses an endoscope to perform an examination of the uterine cavity, often requiring the use of a mild general anesthetic or a sedation medication. These were found to be harder on the patient and have been primarily replaced by a saline sonohysterogram, also known as a hysterosalinesonogram (HSS). A HSS allows specialists to view abnormalities in the uterine cavity by the use of sound waves to create pictures and visualize the inside of the uterine cavity in 3D and 4D, rather than x-rays like in the HSG.

Does HSG have any benefits?

An HSG can disclose any uterine or Fallopian tube abnormalities that could be impairing fertility. As tubal diseases, such as scar tissue or adherence, cause nearly 20% of infertility cases, it is important that an HSG be performed early in the infertility evaluation. Additionally, certain studies have shown that pregnancy rates increased in patients who had a normal HSG. This could be that when the catheter injects the dye into the area, the flow of the dye can at times shift the blockage in the Fallopian tubes, such as endometriosis lesions or anything that was blocking the tube.

If a patient is set to begin fertility treatments with Clomid or hCG (gonadotropin), many times we will suggest they have an HSG performed first, particularly if there is a history of endometriosis or other tubal abnormalities. It’s important to ensure an open and consistent flow, also known as tubal patency, before beginning ovulation induction. This helps to prevent running into any problems after starting an IVF cycle.

Are there any pain or side effects associated with an HSG test?

Patients could experience mild to moderate cramping during the procedure, but it is unlikely that severe pain would result from the HSG. An extremely rare side effect could be an allergic reaction to the dye, which contains iodine. If you have a known iodine allergy, be sure to inform your doctor prior to the HSG. If you experience pain several days after the procedure, this could be indicative of an infection and you should contact your doctor. However, infection is an extremely rare side effect of the HSG

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