Women who are having difficulty conceiving may undergo a hysterosalpingogram as part of the process of diagnosing the cause of the fertility problem.
A hysterosalpingogram, also called a uterosalpingogram, is a diagnostic procedure which is used to investigate a woman’s fertility issues. During this procedure x-ray is combined with contrast fluoroscopy to examine the uterus and fallopian tubes.
During the procedure, the woman’s fallopian tubes and uterus are filled with a high-contrast dye via catheter insertion. Next, the woman undergoes an x-ray. The addition of the dye allows the radiologist to take x-rays that are more detailed and better show the anatomy of the uterus and fallopian tubes. By examining the x-rays, the radiologist can look at the shape and structure of the organs, look at whether the fallopian tubes are blocked, and whether any scarring exists which might prevent pregnancy.
In addition to examining the structure of the fallopian tubes and uterus, the radiologist can also look at whether any abnormal growths are present in the organs. These might include tumors, uterine fibroids, or adhesions, any of which might prevent pregnancy and in the case of malignant tumors may pose a significant risk to the woman’s health.
A third use of the procedure is to examine the fallopian tubes after surgery such as tubal ligation or to remove a fallopian tube blockage.
Preparing for a Hysterosalpingogram
The best time to undergo hysterosalpingogram is approximately one week after a period, but before ovulation occurs again. This is important because the procedure should not be carried out on a pregnant woman due to the risk of x-ray exposure to a developing fetus. Women with pelvic infection or a sexually-transmitted infection should notify their doctor, and may also need to inform the technician performing the procedure.
The procedure is best performed when the bowels are empty, so a woman undergoing hysterosalpingography may be asked to take a laxative, or an enema, before the procedure.
Prior to the procedure itself, a mild sedative is usually given to help the woman relax and minimize discomfort. During the procedure a speculum and then a catheter is inserted into the vagina, so there is some discomfort involved. However this is usually minimal and the procedure takes less than thirty minutes to complete.
After the procedure is over some mild cramps and vaginal spotting may occur for a day or two. This is normal and doesn’t indicate any dangerous complications. Women with pelvic infection or a sexually-transmitted infection may find their symptoms worsen temporarily.
References
Advanced Fertility Center of Chicago: Hysterosalpingogram
Radiological Society of North America, Inc: Hysterosalpingography
