Hysterosalpingogram (HSG) - information for patients

Information for patients hysterosalpingogram (HSG)

You have been invited to have a hysterosalpingogram (HSG) in the fluoroscopy suite at Addenbrooke’s hospital (X-ray level 3, follow signs to ultrasound).

A hysterosalpingogram is an X-ray examination to assess the shape of the uterine cavity (womb) and fallopian tubes for any abnormalities and blockages. This can then be used to help plan any treatment you might need or help reassure you of normality. It is an outpatient procedure and usually takes less than half an hour to perform.

How do I prepare for a hysterosalpingogram?

The HSG is performed ideally before day 10 of your cycle but you must not be bleeding. Occasionally your appointment may be booked just after day 10, if this is the case you must abstain from sexual intercourse from day 10 to your appointment. This is to ensure you are not pregnant at the time of the test and to comply with national and European guidelines (IRMER). When you attend for your procedure you will be asked to confirm that you are not pregnant. You must let us know if you think you are pregnant. Please telephone the fluoroscopy department on day 1 of your cycle so an appointment can be booked on 01223 216455 (Monday to Friday, 09:00 to 16:45 except bank holidays).

Can I bring a friend / relative?

Yes, but for reasons of their safety they will not be able to accompany you into the X-ray room. In order to comply with Trust policy a chaperone will be present during the examination. It is useful to have someone around after the procedure to accompany or take you home in case you are in discomfort.

As Addenbrooke’s is a training hospital there may be the possibility of male staff either performing or assisting with the procedure. You will be asked your permission if male staff may be present.

When you arrive

Please report to the reception desk in the ultrasound department on level 3. A member of staff will then take you to the barium room where you will be asked to change into a hospital gown. You are welcome to bring a dressing gown from home if you wish.

How is a hysterosalpingogram done?

You will be asked to lie on an x-ray table under the x-ray machine. A speculum will be placed into the vagina (like a smear test) to inspect the cervix (neck of womb). A small tube is fitted and the uterus is gently filled with a contrast liquid. The contrast then enters the fallopian tubes to see if they are ‘patent’ / open. The fluid that entered the womb will be discharged from the vagina. Sometimes there will be a few spots of blood. Therefore it is recommended that you bring a pad or panty liner with you. Do not use a tampon.

Is it uncomfortable?

Some patients find they get mild to moderate crampy tummy pain (a period-type pain). This usually stops as soon as the procedure is over. Occasionally discomfort can last for several hours so a simple pain killer such as paracetamol or ibuprofen can be taken. Some patients like to take pain relief one hour before the procedure.

What are the risks?

An HSG is considered to be a very safe procedure. Infection of the fallopian tubes is a rare complication (less than 1 in 100). You should contact your GP if you experience lower abdominal pain lasting more than 24 hours, a temperature or an offensive vaginal discharge.

Rarely a patient may have an allergy to iodine used in the contrast given. If you have previously reacted to intravenous injection of contrast (the same contrast used for a CT scan) you must inform the staff.

Radiation exposure is very low (<1mSv) and does not have any effect on conceiving after the procedure.

You have been referred for an x-ray examination to help make a diagnosis or monitor your treatment. A specialist in radiology agrees that this is the best test to answer the clinical question that has been asked and that the benefit of the examination is greater than the risk. The x-ray involves a very low dose of ionising radiation equivalent to a few days or weeks of natural background radiation which we are all exposed to every day. Ionising radiation can cause cell damage that may turn cancerous however the risk of this happening from your examination is considered minimal. The dose delivered will be kept as low as is practicable.

What happens next?

After the HSG you can go home and return to normal activities including sexual intercourse. You may drive if you feel comfortable. Bleeding or spotting may persist for a day or two. In this case, use pads or panty liners not tampons. The images will be examined after your visit and a written report sent to your referring doctor, which is usually available in 7 to 14 days.

Alternatives

Occasionally the procedure cannot be completed and you may need to book for another procedure such as a laparoscopy.

Contacts / further information

If necessary please contact the fluoroscopy booking team on 01223 216455 or your referring clinician.

References / sources of evidence

Infertility Guidance Service - Hysterosalpingography - Treatments and investigations (opens in a new tab)