Testing Female Infertility using Hysterosalpingogram

A hysterosalpingogram (HSG) or uterotubogram is often used to detect if and where the fallopian tubes are blocked. Sometimes, it also detects problems in the uterine cavity such as congenital uterine anomalies, polyps, fibroid tumors or uterine scar tissue. It is usually done in the first week of your cycle. The whole process lasts about half an hour.

During the HSG, a special instrument called a cervical cannula or a balloon catheter is placed into the uterine cavity through the cervix. A radio-opaque dye is injected slowly into the uterine cavity through the cervix under pressure and X-rays of the uterine cavity are recorded.

A normal HSG represents the uterine cavity as a triangle. From here the dye enters the fallopian tubes that appear as two long thin lines on either side of the cavity. A smudge like appearance indicates the the dye spills into the abdomen from an open tube. If there is a problem, a gap may be shown in the uterine cavity. If the tube is blocked at the cornual or uterotubal end, then the dye will not enter the tubes and they are not visible. If the block is at the fimbrial end then the dye enters the tubes but does not spill into the abdominal cavity. The end of the tubes appear swollen. But the dye may not be seen in the tubes when there is tubal spasm. So, if the HSG is abnormal a laparoscopy would have to be performed.

There are very few complications associated with HSG, such as rashes because of dye allergy, pelvic infection or uterine perforation. But, these are very rare.