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Hysterosalpingogram Procedure and Its Complication

  • 4.8 (5 Votes)

HSG is a X ray test that is done before the IVF treatment or IUI treatment to look around the area of fallopian tubes and uterus. It is important before IVF or IUI

A hysterosalpingogram (HSG) is a type of X-ray test. It is done to look at the inside of the uterus and the condition of fallopian tubes and the area around the uterus It is often done for the women who are having a hard time in getting pregnant or they are infertile. This test is done before IUI treatment or IVF treatment to see the problems inside. What can be the cause of infertility can be checked via this test as HSG is sometimes important before IVF treatment or IUI treatment. 

During the HSG test, a dye ( a type of contrast material) is put through a thin tube inside. That tube is put inside through the vagina and straight into the uterus. Because the uterus and both the fallopian tubes are hooked together, the dye will then flow into the fallopian tubes. Pictures and screening are taken using a steady beam of X-ray (fluoroscopy) as the dye passes through the uterus and fallopian tubes.

The pictures can show the issues and problems such as an injury or abnormal structure of the uterus or fallopian tubes formed. HSG X-ray can also screen a blockage in the fallopian tubes that would prevent an egg moving through a fallopian tube to the uterus. A blockage in the fallopian tubes also could prevent sperm from moving into a fallopian tube and joining (fertilizing) an egg to conceive. HSG test also may find problems inside of the uterus that strongly prevents a fertilized egg from attaching (implanting) to the uterine wall. These problems can be managed with IVF treatment or IUI treatment and to judge inside condition to proceed with IVF treatment or IUI treatment. 


Why It Is Done

A hysterosalpingogram (HSG) is done to:

1- HSG is done to check for a blocked fallopian tube. The HSG test often is done for a woman who is having a hard time in getting pregnant or conceiving. An infection inside may cause severe scarring of the fallopian tubes and can block the tubes. This can prevent pregnancy and reduce the chances of getting pregnant. Once in a while, the dye used during the HSG test will push through and open a blocked tube also.

2- This HSG procedure helps in finding problems in the uterus and fallopian tubes, such as an abnormal shape or structuring. The test can also look for an injury inside, polyps, fibroids, adhesions, or a foreign object in your uterus. These types of severe problems may cause very painful menstrual periods or repeated miscarriages or failed pregnancy.

3- This HSG is done to see if tubal implants for permanent birth control are blocking the fallopian tubes.

4- This HSG is done to see if surgery to reverse a tubal ligation has been successful.

How It Feels

You will feel some cramping or severe pain like menstrual cramps during the HSG tests. The severe pain you will have will depend on what problems the doctor finds and treats during the test of HSG X-ray.

iui. iui procedure


1- In HSG X-ray, there is always some chance of damage to cells or tissue inside from being exposed to any radiation of this type. This can include the lower levels of radiations used for HSG test. 

2- In HSG X-ray, there is a small chance of some kind of pelvic infection after this test. Examples of these are the endometritis and salpingitis. The chance of the infection is higher for women who have had pelvic infections history before. Your doctor may give you antibiotics for this if he thinks that you might get the pelvic infection.

3- In HSG X-ray, there are very little chance of damaging or puncturing the uterus or the fallopian tubes during this test.

4- In HSG X-ray, there are very little chances of an allergic reaction to the iodine X-ray dye that is inserted inside. This is more common if you are allergic to any type of shellfish.

5- In the rare cases, if an oil-based dye is been used, the oil can leak into the blood circulation. This can cause blockage of the blood flow to a section of the lungs that is called (pulmonary embolism). But in most of the cases, in this HSG test doctors uses water-based dyes.

After the test

After the test, some of the dye will leak out of the vagina. You also may have some vaginal bleeding for several days after the test. Call your doctor right away if you have:

  • Heavy vaginal bleeding. (This means soaking more than one tampon or pad in 1 hour.)
  • A fever.Severe belly pain.
  • Vaginal bleeding that lasts for more than 3 to 4 days.

To know about home remedies and natural ways to beat the pain during your periods. read our article on Beat Menstrual Cramps. In case you have being suffering from more specific gyne problems and you are in India then you can explore our article on Top Gynecologist.

Dr. R K Sharma

About The Author

Reproductive Endocrinologist, Hysteroscopic Surgeon Dr. R K Sharma

Dr. R K Sharma has completed MBBS and MD in Obstetrics and Gynecology from Pune University in 1981 and 1989 respectively. Dr. R K Sharma is one of the pioneers in the field of IVF treatment in India. He specializes in IUI, IVF, Embryo transfer and Hysteroscopy procedures. He is also a member of Federation of Obstetrics and Gynecology Societies of India (FOGSI). Dr. R K Sharma is presently practicing at Primus Super Specialty Hospital, Chanakyapuri, Delhi. To know more, visit


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Sangeeta Roy

I was aware of the consequences of HSG and after reading this article, I think I am able to opt it. Wish me luck!

Oct. 6, 2018, 1:29 p.m. 5.0


Suchita Baxi

I had vaginal bleeding along with bad vaginal discharge after HSG. The process was painful but now I am fine.

Sept. 24, 2018, 2:27 p.m. 4.5


Sachin Negi

I think it's the best way to evaluate infertility in women. Though the risks look horrible.

Nov. 30, 2017, 4:25 p.m. 5.0


Isabella Smith

Due for an HSG before IVF, the after effects of the test are sounding a bit scary to me. Don't know how I'll go about it.

Sept. 16, 2017, 11:14 a.m. 5.0


Sachit Smitha

After reading this, I think it's important that one must get prepared not just physically but mentally too for an HSG test.

April 5, 2017, 11:09 a.m. 4.5

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