The first time I heard the name of the test “hysterosalpingography” I got tongue-tied trying to say it, but the test itself is much simpler than the name! Haha. Well, hysterosalpingography, or simply hSG, is an X-ray test that aims to perform a more detailed examination of the uterus using an iodine-based contrast agent that is injected through the cervix1. Hysterosalpingography checks for barriers in the fallopian tubes, or any other problem that might prevent a woman from getting pregnant. This includes malformations of the uterus, adhesions on the walls of the uterus or tubes, among other issues. It is not an invasive procedure like a surgery, but hysterosalpingography can be uncomfortable due to the application of the contrast and the pain it may cause.
The contrast is administered while the patient is in the gynecological exam position, using a very thin cannula that enters the uterus and releases the liquid. This liquid travels inside the uterus, showing clearly on the image whether or not there is any obstruction in any part of the uterus. After the contrast is inserted, a series of X-rays is taken to show different angles of the uterus, allowing for an accurate medical diagnosis. With the hysterosalpingography results, the doctor can assess whether intervention is needed to clear any blockages or resolve adhesions in the uterine walls. These problems are the cause of many cases of unexplained infertility. So, if you have been trying to get pregnant for a while and nothing has shown up in your hormone tests or your partner’s tests, it may be time to ask your gynecologist about this exam.
Adhered tubes prevent sperm from reaching the egg, and in some cases can also prevent a fertilized egg from reaching the uterus to implant2. I’ve heard people say that hysterosalpingography helps you get pregnant, but that’s not exactly true. Of course, if there is a problem causing difficulties, the doctor may choose to do a minor surgery, and in some cases this is done at the time of the exam, but just taking the exam itself without resolving the problem is not enough. A procedure must be carried out by the doctor.
Where to Have a Hysterosalpingography
Hysterosalpingography should be performed at specialized laboratories that are prepared for this procedure. Not because it is particularly difficult, since it is actually very simple, but the contrast can sometimes cause pain (cramps)3, and sometimes greater support may be needed if the patient has an allergic reaction to the contrast (which is very rare). Hysterosalpingography should be performed right after menstruation, as the procedure involves two factors—contrast and X-rays—that could be harmful to a potential pregnancy. I’ve heard people say that hysterosalpingography helps you get pregnant, but it’s not exactly the case. Of course, if there is a problem getting in the way, the doctor may choose to perform minor surgery, and sometimes this can be done at the time of the exam, but just doing the exam itself without resolving the issue still requires a proper procedure guided by the doctor.
The procedure to unblock the fallopian tubes can be done through surgery and, in more severe cases of tube hardening or fluid buildup caused by infections, the doctor will prescribe the appropriate medications. If the problem is just this, pregnancy can happen shortly after the procedure, and that’s why this exam has become the latest “miracle” test. It is always important to emphasize that infertility must be investigated in the couple, not just the woman, as this can save time in case a surgical procedure or medication is needed. Hurray for hysterosalpingography!
I hope this was helpful!
