Tubal evaluation through hysterosalpingogram (hsg)

Infertility in a woman can be called the inability to conceive whereas in a man, it can be stated as the inability to impregnate. It can lead to depression for the couple trying to conceive a baby for long. The reasons for infertility can be many and need proper diagnosis to evaluate and treat the same. The lack of knowledge prevalent in the country and the conservative attitude towards discussing the problem with experts are a big deterrent. To be able to address any problem, the foremost thing is to learn about it and get a thorough diagnosis done. One such diagnosis for infertility includes tubal evaluation in women through Hysterosalpingogram.

An HSG is considered a very safe procedure and is also the most commonly performed evaluations to assess tubal patency. It involves passing a radiographic contrast dye (iodine dye) through the cervix into the fallopian tubes and the uterus via an injection and then taking x-ray to determine the uterus shape and status of the tube. If the dye fills the tube and the abdominal cavity, it indicates that the tubes are open whereas if it is concentrated at one place in the x-ray and hasn’t passed through the tube completely, it reflects blockage, which is then treated for by the specialists. The test only lasts for a short span of time. It is performed between the period finishing and ovulation beginning date, i.e. between day 10 and 12 of the menstrual cycle.

What is tubal evaluation?

Nearly 30% of the women facing the infertility issue may suffer from a problem with fallopian tubes or also called uterine tubes. The egg travels in women from ovary to the uterus through these tubes. The ovum and sperm converge in the fallopian tube which leads to a successful pregnancy. If the tube is blocked, the process will not advance. This is the most common issue with uterus tubes, blockage or scarring in the tube that prevents women from conceiving. It can also be a result of infection that may lead to blockage or distortion of the tube. It is vital to check that the fallopian tube is in a healthy condition and unblocked for pregnancy to be successful, thus the importance of tubal evaluation.

What is Hysterosalpingogram (hsg)?

The hsg test is an x-ray based diagnosis of the uterus and fallopian tubes to determine if the tubes are open and the uterus cavity is normal. It signifies that the tubes will allow for sperm and ovum to converge freely. It also helps in identifying structural defects in the uterus that can complicate the pregnancy and lead to multiple miscarriages.

What to expect in the hsg test?

HSG or hysterosalpingogram is an x-ray procedure done to determine whether the fallopian tubes are open (patent). Plus, it also checks if the shape of the uterine cavity is normal or not. It usually takes not more than 10 minutes to perform and is mostly done before ovulation and after the menstrual period has ended. Most doctors perform a tubal evaluation through hysterosalpingogram only for diagnostic reasons.

The procedure can cause mild or moderate uterine cramping for about five or ten minutes but some women can even experience pain for several hours. In such cases, the cramps can be reduced by taking medications used for menstrual pains. This procedure can also be done under anaesthesia so that patient will not experience any kind of pain. Studies indicate that there is a slight increase in fertility lasting about three months after a normal HSG.

If it is found that your tubes are blocked, the doctor is likely to recommend a surgical procedure to directly view the tubes (laparoscopy). Depending on the condition, this is a complex decision that must be discussed with your partner as well as your doctor.

An hsg is a safe procedure if it is done by experts under clean and hygienic conditions. There have been less than 1% cases of infection resulting from an hsg test.