An HSG (hysterosalpingogram) is a 5-10-minute X-ray test that checks whether your fallopian tubes are open and whether your uterus is normally shaped. It is one of the most common fertility tests in India, generally priced at ₹2,500-₹6,000, and recovery takes hours, not days. Most women return to normal activity the same day.
HSG stands for hysterosalpingogram. It is an X-ray procedure used to see whether your fallopian tubes are patent (open) and whether the inside of your uterus is normally shaped. A small amount of iodine-based contrast (a liquid that shows up white on X-ray) is gently passed into the uterus through the cervix. As the contrast flows into the fallopian tubes and spills out at the ends, the radiologist or fertility specialist captures images to determine whether the tubes are open, partially blocked, or fully blocked, and whether the uterus has any abnormalities, such as adhesions or a structural issue.
The HSG itself is short, but the experience involves a few moving parts - preparation, the procedure, and a few hours of mild cramping. Knowing what each stage looks like makes the test much less stressful.
HSG is done in the first half of your menstrual cycle, usually between Day 7 and Day 12 - after your period has ended but before ovulation. This timing rules out an early pregnancy and gives the clearest images. Most centres ask you to take a mild pain reliever, such as ibuprofen, about an hour before the test to reduce cramping, and some prescribe a short course of antibiotics if there is any risk of infection. You can eat normally and do not need to fast. Bring a sanitary pad - light spotting afterwards is common - and ideally have a family member or friend with you for the journey home.
You will lie on an X-ray table, similar to a routine pelvic exam. A speculum is placed in the vagina, the cervix is gently cleaned, and a thin cannula (a small tube) is positioned at the cervical opening. The fertility specialist or radiologist then slowly injects a small amount of contrast dye into the uterus while the X-ray fluoroscope captures real-time images. As the dye fills the uterus and flows into the tubes, you can usually see the images on a monitor. The whole procedure takes 5-10 minutes.
This is the most common worry, and the honest answer is: most women feel cramping similar to a strong period for a few minutes during the dye injection, and that settles within 5-30 minutes. A small group experiences sharper pain, especially if the tubes are blocked, and the dye has to push against resistance. Pain relief taken before the test makes a meaningful difference. You will not be put to sleep - HSG is done while you are awake, but the discomfort is short and self-limiting.
You can usually walk out of the clinic within 15-20 minutes of the test ending. Light spotting and mild cramping for 1-2 days are normal. Most women return to work the same day or the next, and household activity, walking, and light exercise are all fine. Your specialist may ask you to avoid intercourse, swimming pools, and tub baths for 2-3 days while the cervix settles. If you develop a fever, heavy bleeding, or worsening pain after 24 hours, contact your specialist promptly - this is uncommon but worth taking seriously.
Results usually come the same day or within 24 hours. A normal HSG shows contrast filling a regularly shaped uterus and spilling freely from both fallopian tubes. An abnormal result may show one or both tubes blocked, a hydrosalpinx (fluid-filled blocked tube), filling defects in the uterus from polyps or adhesions, or a structural variant such as a uterine septum or bicornuate (heart-shaped) uterus. The next step depends on what is found.
HSG is considered a very safe outpatient test. Serious complications happen in fewer than 1 in 100 cases. The recognised side effects and risks include:
• Cramping: the most common side effect - usually 5-30 minutes, similar to strong period pain, manageable with mild pain relief.
• Light spotting: can last 1-2 days after the test; heavy bleeding is unusual and should be reported.
• Pelvic infection: rare, occurring mostly in women with a history of pelvic infections or chlamydia. Antibiotic cover and sterile technique further reduce this risk.
• Faintness or dizziness: a small number of women feel light-headed during or just after the test; resting briefly resolves this.
• Iodine allergy: rare. Tell your specialist in advance if you are allergic to iodine, contrast dyes, or seafood; a non-iodine alternative or a different test can be arranged.
• Radiation exposure: very low - less than a routine kidney or bowel X-ray. It has not been shown to cause harm to a future pregnancy.
• Vaso-vagal response: a brief drop in heart rate causing nausea or sweating, which settles quickly with rest.
A little preparation makes the test smoother and more comfortable:
• Schedule the test between Day 7 and Day 12 of your cycle - after your period ends and before ovulation.
• Avoid intercourse from Day 1 of your cycle until the test, to rule out an early pregnancy.
• Take the pain-relief medication your specialist recommends about an hour before the procedure.
• Wear loose, comfortable clothing and bring a sanitary pad for after the test.
• Tell your specialist about any iodine allergy, asthma, kidney issues, or pelvic infection history before the day of the test.
• Arrange for someone to accompany you home if you tend to feel light-headed after medical procedures.
• Eat a light meal beforehand - fasting is not needed and may make you feel weaker.
Recovery is usually straightforward, but a few small habits help:
• Use sanitary pads, not tampons or a menstrual cup, for the first 2-3 days while the cervix settles.
• Avoid intercourse, swimming pools, and tub baths for 2-3 days, or as long as your specialist advises.
• Resume normal activity, walking, and light exercise the same day or the next; there is no required bed rest.
• Take simple pain relief if cramping persists for a few hours - this is normal.
• Watch for warning signs - fever, heavy bleeding, foul-smelling discharge, or worsening pain after 24 hours - and contact your specialist immediately if they appear.
• Discuss the report with your fertility specialist within a week so the next step is clear, whether that is timed intercourse, IUI, IVF, or further evaluation.
An HSG is not aroutine screening test. Your fertility specialist will recommend it when thereis a reason to evaluate your tubes or uterus.
If you havebeen trying to conceive without success or your specialist has suggested anHSG, you can book a fertility consultationat a Cloudnine Fertility centre to plan the test, the timing, and the stepsthat follow.
An HSG gives astructural answer, not a verdict. The table below shows how typical findingstranslate into next steps in fertility care.