What to expect during an HSG Test?

Posted by Shaheen Shaikh on June 15th, 2021

If a woman is looking to resolve any issues about her reproductive health or evaluating fertility treatment options to choose from, one of the few tests she may be prescribed is the HSG. The hysterosalpingogram (HSG) test, also called hysterosalpingography or uterosalpingography, is conducted to get a better picture of the health of your uterus and fallopian tubes. It involves injecting a dye into your uterus, through the vaginal opening, to evaluate the shape and patency of your uterus and fallopian tubes.

The test helps determine if the uterus and fallopian tubes are healthy and without any blockages, to allow for further steps. While the test is conducted in a single session that may not take more than about thirty minutes, it is always advisable to gather more information about what to expect during an HSG test. This helps you prepare better so that you have a successful session and know what to expect after the test.

What is the HSG Test?

A complete and detailed picture of your reproductive health needs to be understood before your fertility issues can be resolved or a mode of treatment can be recommended. The HSG is one of these pre-treatment tests that aid you in making a more informed decision.

The test is meant to examine the health of your uterus and fallopian tubes, which form a part of your reproductive system. Issues in conception could arise due to fallopian tubes being blocked or the inside of the uterus not being healthy. It is with the HSG test that these issues are detected and rectified, if possible. The future course of treatment is decided upon based on the results. A contrast medium, which is essentially a dye fluid, is introduced into your uterus. This medium shows up in the X-ray images, thus highlighting the shape of your uterus and whether your fallopian tubes are sans any blockages.

What to Expect from the HSG Test?

Following are some of the steps you can expect to encounter during the course of your HSG test:

• You will be asked to position yourself as you usually would for a pelvic exam. If you are familiar with pelvic exams, the additional element here would be an X-ray machine that is positioned over your torso to capture your uterus and fallopian tube x-rays.
• A speculum, which is an instrument shaped like a duck’s bill, will be inserted into your vagina. This is used to dilate your vaginal walls and hold the orifice open during the course of the procedure. While this may induce discomfort, it shouldn’t feel painful. If the speculum hurts, or if you have experienced pain during previous pelvic exams or sexual activities, let your doctor know.
• Next, the cervix will be cleaned and prepped for the procedure. Anaesthesia may be introduced if deemed necessary. This may feel like a pinch.
• Then the dye is introduced in the uterus. This may be done with a cannula or a small plastic tube. The dye is iodine-based and will show up in contrast through the X-ray.
• After the fluid is filled in, you will be positioned for the X-ray. You may also be asked to turn sideways. If this feels uncomfortable, do not hesitate to ask for help.

What are some important points to remember about the HSG Test?

• The HSG test is usually conducted in the follicular phase, the days after your menstruation has ended but before ovulation begins. If you have reason to believe that you are pregnant or may have an infection, inform your doctor before the test. It is not advisable to do an HSG under these circumstances.
• Some people experience an allergic reaction to the iodine-based dye. If you know that you are allergic, or have experienced an allergy to iodine, speak about it to your doctor.
• You may experience varying degrees of discomfort during the test. But if you feel pain, alert the professionals attending to you. This may not be normal, or they may be able to help you with it.
• If you have any blockages in the tubes, or if the contrast medium comes across any obstacles, you may feel tension or pain in the region. Bring this to the attention of the doctor.
• The contrast medium will normally drain out into the body, out of the ends of your fallopian tubes. The process is not meant to examine your ovaries.
• After the test, you may experience cramps. This is different for every person. You can choose to take a cramp relief medicine that you usually take for period cramps or ask your doctor to provide you with one. If you are especially susceptible to cramps, ask your doctor about cramp relief medication that can be taken before the procedure.
• If the pain or discomfort lasts longer than a few hours after the procedure or doesn’t subside, consult your doctor.
• Once you are done with the test, there may be slight spotting or bleeding. This should not last long after the procedure.
• You may be asked to refrain from sexual activity for a while after the test.
• It is advisable to take someone with you as cramps may cause you some discomfort.
• While infections are rare, fever, discomfort, cramps, or any such symptoms may indicate one. Bring this to the attention of your doctor.

Understanding Your HSG Results

Primarily, you will be informed of two things after this test –

1. The shape of your uterus
2. The patency (openness) of your fallopian tubes

The test results are considered normal if the fallopian tubes are open, allowing the dye to spill out the ends, and if the shape of the uterus looks to be normal.

HSG tests only analyse a part of your reproductive system. There may be other problems that will be detected through other procedures, if necessary. Consult your gynaecologist for any issues that you may come across before, during, or after the procedure.