HSG X-Ray Scan

A Hysterosalpingogram, commonly known as an HSG, is a specialized X-ray examination that provides crucial insights into a woman's reproductive health. This minimally invasive procedure is a cornerstone of fertility assessment, designed primarily to evaluate the internal shape of the uterus and determine the patency (openness) of the fallopian tubes. If you and your doctor are investigating reasons for difficulty conceiving, the Hysterosalpingogram (HSG) is often one of the first and most important diagnostic steps. It is widely regarded as the most common and effective fallopian tube test available today, offering clear answers and guiding the next steps in your fertility journey.

What is a Hysterosalpingogram (HSG)?

At its core, a Hysterosalpingogram (HSG) uses a type of real-time X-ray called fluoroscopy combined with a special iodine-based contrast medium (dye). The procedure is straightforward yet highly informative.

A small amount of this contrast dye is gently introduced into the uterus through a thin catheter. As the dye fills the uterine cavity and travels into the fallopian tubes, the radiologist can observe its movement live on a monitor. This process creates a clear outline of these internal structures on the X-ray images. It allows our expert radiologists at Cadabams Diagnostics to precisely assess the size and shape of your uterus and, most importantly, visualize whether the fallopian tubes are open and allowing the dye to spill into the pelvic cavity, or if they are blocked.

Types of HSG

While patients generally undergo one standard HSG procedure, the main variation lies in the type of contrast material used. Your referring doctor and our radiologist will determine the best option for your specific case.

Oil-Based vs. Water-Based Contrast

The dye used can be either oil-soluble or water-soluble. Both are effective, though some studies suggest a slightly higher therapeutic benefit (increased chance of pregnancy post-procedure) with oil-based contrast.

Salpingography vs. Hysterography

Technically, an HSG combines two processes. "Hysterography" refers to imaging the uterus, while "salpingography" refers to imaging the fallopian tubes. The Hysterosalpingogram (HSG) evaluates both simultaneously for a complete picture.

During the procedure, our radiologist carefully assesses several key parameters to build a comprehensive diagnostic report for your doctor:

• Uterine Cavity: We examine the shape, size, and contour of the uterine cavity to identify any abnormalities like fibroids, polyps, adhesions (scar tissue), or congenital anomalies such as a septate or bicornuate uterus.
• Fallopian Tubes: The primary goal is to assess patency. We look to see if the contrast dye flows smoothly and completely through both fallopian tubes.
• Tubal Abnormalities: We identify the presence and location of any blockages (occlusions). We also look for signs of a hydrosalpinx, which is a specific condition where a blocked tube becomes swollen and filled with fluid.
• Peritoneal Spill: This is a key indicator of open tubes. We look for confirmation that the dye has passed through the tubes and spilled freely into the pelvic (peritoneal) cavity.

Your doctor may recommend a Hysterosalpingogram (HSG) if you are experiencing any of the following:

• Inability to Conceive: Difficulty getting pregnant after one year of regular, unprotected intercourse (or after six months if the woman is over 35).
• Recurrent Pregnancy Loss: Having two or more consecutive miscarriages.
• Pre-IVF Assessment: To evaluate the uterine structure and tubal health before proceeding with assisted reproductive technologies like In-Vitro Fertilization (IVF).
• Post-Tubal Reversal Surgery: To confirm that the fallopian tubes have been successfully reopened.
• Suspected Uterine Adhesions: If there is a suspicion of intrauterine scarring (Asherman's syndrome), often resulting from previous surgeries or infections.

This procedure serves as the most reliable initial test for blocked fallopian tubes and other structural issues.

When and Who Needs to Take an HSG?

An HSG is typically recommended by a gynecologist or fertility specialist when there is a need to evaluate the structural integrity of the uterus and fallopian tubes. The most common indications include:

• Investigation of Infertility: This is the primary reason for performing an HSG. It is recommended for couples who have been trying to conceive without success.
• Recurrent Miscarriages: Structural abnormalities in the uterus can sometimes lead to recurrent pregnancy loss. An HSG can help identify these issues.
• Post-Surgery Evaluation: It is used to check the success of tubal surgery, such as a tubal ligation reversal, to ensure the tubes are now open.

For women seeking answers about their fertility, the HSG is the definitive test for blocked fallopian tubes, a common cause of infertility.

Benefits of the XR HSG Test

The insights gained from an HSG are invaluable. The key benefits include:

• Essential Diagnostic Information: It provides clear, actionable information that is critical for planning the most effective fertility treatment.
• Identifies Correctable Issues: The test can pinpoint structural problems, like polyps or some fibroids, which may be correctable with surgery, potentially restoring natural fertility.
• Minimally Invasive: It is a non-surgical procedure that provides a high level of diagnostic accuracy with minimal risk and downtime.
• Potential Therapeutic Benefit: A well-documented phenomenon is a slight increase in fertility rates in the 3-6 months following an HSG. It's believed that the flushing action of the dye may clear minor blockages or mucus plugs.

Conditions Diagnosed with XR HSG Test

An HSG is instrumental in diagnosing several conditions that impact fertility:

• Blocked Fallopian Tubes (Tubal Occlusion): This is the most common diagnosis, where one or both tubes are blocked, preventing the egg and sperm from meeting.
• Hydrosalpinx: A specific and serious form of tubal blockage where the end of the tube is sealed and fills with toxic fluid, which can negatively affect embryo implantation.
• Uterine Anomalies: This includes congenital issues present from birth (like a bicornuate or septate uterus) and acquired problems that develop over time (like submucosal fibroids, endometrial polyps, and uterine scarring).

Proper preparation is key to a successful and comfortable HSG experience.

• Timing is Critical: The test must be scheduled for after your menstrual period has ended but before you ovulate. This window is typically between days 6 and 10 of your menstrual cycle (with Day 1 being the first day of your period).
• Discuss Allergies: Be sure to tell the booking staff and the radiologist at Cadabams Diagnostics if you have any allergies, particularly to iodine, iodinated contrast dye, or shellfish.
• Pain Relief: We recommend taking an over-the-counter pain reliever, such as Ibuprofen, about 60 minutes before your scheduled appointment to help minimize cramping.
• Antibiotics: Depending on your medical history, your referring doctor may prescribe a prophylactic (preventive) antibiotic to take before and/or after the procedure.

Pre-requisites

For your safety, there are two mandatory pre-requisites for the HSG test:

1. Negative Pregnancy Test: A pregnancy test will be performed at the clinic before the procedure begins. The HSG cannot be performed if there is any chance you might be pregnant.
2. Doctor's Referral: You must have a referral (prescription) from your gynaecologist or fertility specialist to undergo the test.

Best Time to Take the HSG

To reiterate, the timing of your Hysterosalpingogram (HSG) is extremely important. The ideal time is in the follicular phase of your menstrual cycle, specifically between Day 6 and Day 10. Scheduling the test during this window ensures that you are not pregnant and that the lining of your uterus (endometrium) is thin, which allows for the clearest possible images of the uterine cavity.

Eligibility

The HSG is a safe and appropriate procedure for most women undergoing an infertility evaluation. However, there are specific situations where the test is contraindicated.

Who should NOT take the test:

• Women who are confirmed or suspected to be pregnant.
• Women with an active Pelvic Inflammatory Disease (PID) or any other acute pelvic infection.
• Women with a known severe allergy to iodinated contrast material.

Procedure for Taking a Hysterosalpingogram (HSG)

Understanding the hsg test procedure step-by-step can help you feel more prepared and relaxed. The entire process at Cadabams Diagnostics is handled with the utmost care for your comfort.

Step 1: Positioning

You will be asked to lie on your back on an X-ray table with your feet placed in stirrups, similar to a routine pelvic exam.

Step 2: Speculum and Cleaning

The doctor will gently insert a speculum into the vagina to visualize the cervix. The cervix is then carefully cleaned with an antiseptic solution.

Step 3: Catheter Insertion

A very thin, flexible tube called a catheter is passed through the opening of the cervix and positioned just inside the uterine cavity.

Step 4: Contrast Injection

The radiologist will then slowly inject the contrast dye through the catheter. As the dye fills your uterus, you may feel some pressure or cramping. This sensation is normal and usually subsides quickly.

Step 5: X-ray Imaging (Fluoroscopy)

As the dye moves from the uterus into the fallopian tubes, the radiologist will take a series of real-time X-ray images. They will track the path of the dye to see if it fills the tubes and spills out the ends. You may be asked to gently shift your position to help visualize the anatomy from different angles.

Duration: The entire hsg test procedure is quite fast, typically taking about 15 to 30 minutes from start to finish.

Caution Before Taking the Test

For your safety, it is essential that you communicate openly with our medical team. Before your test, please be sure to inform us about:

• Any possibility, however small, that you might be pregnant.
• All known allergies, especially to iodine, X-ray contrast materials, or shellfish.
• Any current symptoms of a pelvic infection, such as unusual discharge or pelvic pain.
• Any bleeding disorders or if you are taking blood-thinning medication.