Have you and your husband been hoping for a baby for a while now? At that time, the doctor will ask you to do various tests to check your fertility. Among them, have you heard of the 'HSG' test? You may feel a little scared when you hear this name. But it is actually a very important, and not as difficult, and simple test as you think. Let's talk about it all clearly today.
What is a Hysterosalpingogram (HSG)?
Simply put, an HSG is a special X-ray test. It mainly looks at the inside of your uterus and fallopian tubes . In this test, a special liquid, called a dye, is injected into your uterus and an X-ray is taken to see how it moves through your fallopian tubes.
Imagine that we have a plumbing system in our house. It's like we're running some dye through it to see if there's a blockage somewhere. This dye makes the uterus and fallopian tubes very clearly visible on an X-ray.
Why is this HSG test so important?
To conceive a child, the fallopian tubes must be healthy and open. Because, a sperm meets an egg and fertilizes it inside this fallopian tube. Then, the embryo that develops comes back to the uterus through this tube. So if these fallopian tubes are blocked, none of this will happen. Today, the main reason for delaying having children, that is, infertility, is the blockage of these fallopian tubes.
The HSG test mainly checks for these things. In addition, it can check for several other things.
- You can know exactly whether the fallopian tubes are open or blocked.
- If you have previously had a tubal ligation , a type of family planning procedure, check to see if it was successful. You can also check to see if the procedure was successful if it was reversed (tubal reversal).
- This can also help you get an idea of things like abnormalities in the shape of the uterus, uterine tumors ( fibroids ), etc. If you see anything like that, your doctor may order further tests like sonohysterography or hysteroscopy .
Things you need to know before the test
Before performing this test, the doctor will advise you on several things.
When will this be done?
The HSG test is usually done after your period has completely finished but before ovulation. That is, within the first two weeks of your menstrual cycle. This is done to make sure that you are not pregnant at the time of the test.
Who should not take this test?
This test is not performed if you suspect you are pregnant or if you have a pelvic infection .
How to prepare for the test?
Follow the doctor's instructions exactly. Usually, you can say things like this:
- You may be asked to take a painkiller (e.g. paracetamol) about an hour before the test.
- You may be asked to start antibiotics early to prevent infection.
- Arrange for someone to drive you home after the test. You may be able to drive yourself, but sometimes it can be difficult with a minor stomach ache, so it's safest to go with someone.
How to do an HSG test - don't be afraid, this is how it happens!
The entire test takes less than 5 minutes, so there's no need to worry about it. You can go home the same day.
1. Preparation: You will be made to lie on a bed, similar to a pelvic exam. An X-ray machine ( fluoroscopy machine ) will be placed over your abdomen.
2. Inserting the speculum: The doctor will insert a device called a speculum into your vagina and adjust it so that the cervix is visible.
3. Catheter insertion: After the cervix is cleaned, a very fine, thin plastic tube (catheter) is passed through the cervix and into the uterus. Sometimes this tube has a small balloon at the end. When it is inflated slightly inside, the tube stays in one place without moving.
4. Inserting the dye and taking an X-ray: Now the speculum is removed and you are asked to spread your legs wide. Then the doctor carefully passes the dye through the tube into the uterus. At the same time, the X-ray is taken.
You may feel some cramping during this time, similar to your period. This is normal. If your fallopian tubes are blocked, the pressure from the dye may cause the tubes to stretch a little, which may make the cramping a little more intense.
5. Examination: The doctor watches the dye move through the uterus and fallopian tubes on an X-ray monitor. If the tubes are open, the dye will be seen flowing out of the tubes and into the intestinal tract (the dye is absorbed by the body without harm). If the tubes are blocked, the dye will not move further.
6. Finishing: After taking the necessary X-ray images, the doctor takes out the tube. That's it.
What to expect after the test?
The following things can usually happen after the test:
- The extra dye may leak out of the vagina, so you will need to use a sanitary pad.
- You may experience mild stomach cramps for a few hours.
- A few drops of blood may pass for a day or two.
- Some people may experience dizziness and nausea.
You can easily resume your daily activities.
Risks and when to talk to a doctor
HSG is a very low-risk test, but very rarely, the following can happen:
- Infection
- Minor damage to the uterus
- Allergic reaction to the dye
If you experience any of the following symptoms after the test, you should talk to your doctor immediately without hesitation. These could be signs of an infection.
| Warning feature | What you should pay attention to |
|---|---|
| Fever and chills | Increased body temperature or feeling like you have a fever with shivering. |
| Unbearable stomach pain | More than just a normal ache, a severe pain. |
| Heavy bleeding | Bleeding that is heavier than menstruation. |
| A foul-smelling vaginal discharge | Discharge with an unusual odor. |
| Nausea or vomiting | Fainting or continuous vomiting. |
Does the chance of getting pregnant increase after HSG?
Some studies have shown that inserting the dye into the fallopian tubes in this way (also called tubal flushing ) can slightly increase fertility in some women, especially for the next 3-6 months. However, this has not yet been proven as a fertility treatment. Its primary purpose is for diagnostic purposes.
Can HSG remove blockages in the fallopian tubes?
This is related to the previous question. The pressure of the dye can sometimes dislodge very small blockages or mucus in the fallopian tubes. However, it cannot remove larger blockages.
How long after an HSG can you try to have a baby again?
It's usually safe to try again after a few days, but it's best to check with your doctor first.
Based on the results of the HSG test, your doctor will decide what to do next. They may recommend surgery, such as a laparoscopy , if the tubes are blocked. Or they may recommend treatments that do not require the fallopian tubes, such as IVF (in vitro fertilization) .
Take-Home Message
- An HSG is a safe X-ray test that takes just a few minutes to check if your fallopian tubes are blocked.
- If you are having a delay in having children, this is a very important test to find the cause.
- It is normal to feel some mild stomach pain during and after the test. However, if you experience severe pain or symptoms such as fever, inform your doctor immediately.
- The results of this test will be of great help to the doctor in planning your future treatment.
- So don't be unnecessarily afraid of this test. Talk openly with the doctor about any questions or concerns you may have.
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