Dr. Aruna Ashok MBBS, MS OG, DNB OG
- Clinical Director
Aruna Ashok | 20 Sep 2023
The hysterosalpingography is a (HSG) radiographic procedure that is used to visualize the female reproductive organs, especially the uterus and fallopian tubes. When it comes to planning for conception, understanding the functions and anatomy of the reproductive system is crucial. The HSG test is performed by an expert physician to determine the functionality of female reproductive organs like fallopian tubes, uterus, inner lining of the uterus, and so on. The test is also used to analyse if the uterine lining (endometrium) has any irregularities like fibroids, scratches, polyps, and more.
The major purpose of the test is to analyse the appropriate cause of infertility in women and recurring miscarriages. Hysterosalpingography (HSG) is otherwise referred to as hysterosalpingogram.
You might wonder if the question is hsg test painful? Let’s scroll down to know the answer to it.
Listed below are some of the best possible ways to prepare yourself for the HSG test. They are:
Here we are to help you understand how the HSG test is performed. Being aware of the procedure prior can keep you informed and less anxious as you will know what’s going to happen.
When we say procedure, the first question that comes to your mind would be about anaesthesia. The HSG test is generally performed without anaesthesia. The process will take about 15-30 minutes to complete. Furthermore, the procedure doesn’t require you to stay in the hospital, which means you can go home on the same day as soon as the procedure is completed.
In addition, the HSG test can be either performed by the healthcare provider or the radiologist. If done by the radiologist, he will share the findings with your healthcare provider. This allows your provider to plan for the fertility treatment appropriately.
The step-by-step process of the procedure is listed below.
The first step begins with ensuring your pregnancy. The test might be performed if you are pregnant as it involves radiation. Even though a very minimal amount of radiation is used, it might disrupt the growing fetus. Hence, the complete analysis of your conception is performed before the test. When done, the day of the procedure is scheduled. The test is generally performed in the middle of your menstrual cycle which might be around day seven to ten.
Your healthcare provider may prescribe you some pain relief medications and antibiotics before the procedure. This will help with reducing pain to a certain level and manage infections.
The procedure will start by making you lie on your back on the X-ray machine table. Similar position to the pelvic exam. This makes the healthcare provider to have easy access to the pelvic region.
After positioning, the vagina and cervix are prepared and cleaned using saline with a cotton swab before the procedure. This helps to wash away any mucus or dirt present in the pelvic region. The process is generally performed to minimize the chances of infection after the procedure.
Mostly the procedure is performed without anaesthesia. However, in rare scenarios, local anaesthesia will be given in the stroma of the cervix to reduce the pain.
During the HSG procedure, a speculum, which is a medical device is used to widen the walls of the vagina. This will allow the physician to have easy access and clearly visualize the uterine cavity.
After the speculum, the catheter is inserted through the speculum. The Catheter is inserted until it reaches the uterine cavity. The catheter is nothing but a soft and flexible tube, which is used to inject the contrast dye into the uterus, especially in the HSG procedure. This allows the contrast dye to pass through the fallopian tubes.
When done with inserting the catheter, contrast dye is injected through the catheter into the uterus. The dye plays its role in clearly visualizing the functionality of the uterus and fallopian tubes in the X-ray imaging.
When done with injecting the dye, your healthcare provider will take real-time X-ray images of the fallopian tubes and uterus as the dye moves. While taking the pictures, you may be asked to hold your breath for a couple of minutes. In addition, you may also be instructed to change your lying position to enhance the visualization and imaging quality of the uterus and fallopian tubes.
When done with capturing enough pictures, the inserted speculum and catheter are removed.
You might wonder what will happen to the injected dye.
Generally, the injected dye will come out through the uterus, sometimes with the blood, as a sticky vaginal discharge. When the tubes are unblocked, it is crucial to understand that the injected dye will come out from the vagina. In contrast, if they are blocked, the dye won’t come out.
A woman might experience slight vaginal bleeding, cramping, and discomfort after the procedure. When it comes to cramping, the pain may vary anywhere from mild to severe. Having a consultation with your healthcare provider after the procedure is highly suggested. However, the discomfort and other impacts may last only for a day or two.
Your healthcare provider may discuss your results immediately or during the follow-up appointment.
The results can certainly provide a clear idea of the health of your reproductive system. The HSG test results may indicate:
In the X-ray images of the test results, if the injected contrast dye passes through the fallopian tubes and some of them come out from the vagina, it is a clear indication that the tubes are normal and open. With the help of these findings, your healthcare provider may determine that the fallopian tubes are not the cause of your infertility.
If the injected contrast dye strikes in between the fallopian tubes and doesn’t come out after the procedure from the vagina, it is a clear indication that the fallopian tubes are blocked and abnormal.
Even though the HSG test is performed to analyse the performance of the fallopian tubes, the diagnosis of the uterine cavity’s health is also possible. The health of the uterine cavity may be analysed by its shape, and the presence of scarring and adhesions in the pelvis, if any. This allows the healthcare provider to recognize your reproductive health.
In addition to determining adhesions, uterine abnormalities can also be diagnosed through the HSG test. The abnormalities may include fibroids, congenital anomalies, or polyps. The HSG finding results may indicate these abnormalities like a filling defect of the contrast dye in the X-ray imaging.
After the HSG procedure, it is highly advisable to follow the instructions provided by your healthcare provider, including medication and relaxation. Many women find the test to be painless, whereas others may experience some kind of discomfort and pain. However, it is suggested to follow few things that are listed below to enhance your comfort after the procedure. They are:
The HSG test, especially for a woman experiencing infertility and recurring miscarriages, provides several purposes. Some of them are listed below:
No matter what the purpose is, the HSG test is helpful in detecting the appropriate cause of infertility much earlier. This allows the skilled healthcare providers as in A4 Fertility Centres to plan for the right treatment and enhance the chances of achieving successful pregnancy.
It is quite common to experience some kind of side effects in any procedure. Even though the HSG test is considered to be safe, it does contribute to certain side effects. Some of them may include:
It is usual to experience spotting or bleeding after the HSG test. In certain scenarios, a woman may also experience watery discharge from the vagina. These are some of the common side effects of the HSG procedure, which will typically last only for a day or two.
Cramping is the most common side effect of the HSG test. The cramping may vary from mild to severe, depending on the woman’s pain tolerance level and the health of the fallopian tubes. A woman may experience severe cramping if the fallopian tubes are blocked. In contrast, a woman may experience mild cramping if the tubes are open. Generally, the cramping or discomfort will subside within a couple of days after the procedure. If it prolongs, talk to your healthcare provider as soon as possible.
Infection is another common side effect of the HSG test. Infections may happen to women, especially if they have had any diseases in the pelvic region. The interaction between the contrast dye and existing pelvic disease can cause serious infections. Hence, it is always suggested to have an open communication with your healthcare provider regarding your health history.
Note that, if you experience your body temperature to be more than 100˚ F within a day of the HSG test, visit your provider.
Allergic reactions after the HSG test are a rare side effect. Some women may exhibit allergic reactions to the contrast dye, which is used in the procedure. If you experience any severe swelling or itching after the test, talk to your healthcare provider.
Some women experience dizziness or nauseous feel during or after the procedure. However, the complication may be improved in a couple of days. Talk to your healthcare provider if the situation worsens.
Uterine or tubal perforation is an uncommon, but determined side effect of the HSG procedure. Perforation is the rupture that happens in the uterus or fallopian tubes. The perforation occurs when the catheter tears the uterine wall, or the contrast dye is injected forcefully, or an existing infection in the uterus or fallopian tubes.
A woman may experience mild to severe cramping after, sometimes even during the procedure. This may happen because of the uterine contractions or irritations towards the injected contrast dye.
Listed below are some of the tips from experts to manage the pain that occurred because of the procedure.
As prescribed by your healthcare physician, it is suggested to not miss taking any medications. This will help you relieve pain, infection and allergies.
As prescribed by your healthcare physician, it is suggested to not miss taking any medications. This will help you relieve pain, infection and allergies.
It is suggested to have open communication with your healthcare provider about your anxieties and concerns, if any. This can significantly help you relieve your stress.
Never hesitate to ask for emotional support from your loved ones. When it comes to dealing with fertility treatment, emotional support can be a game changer.
Even though the HSG procedure can potentially cause certain discomfort and pain in the woman, it is the most anticipated medical equipment in fertility treatment. Keeping you well informed of what to expect and how the procedure takes place can significantly help you to progress the treatment.
1. Is the HSG test painful?
The pain and discomfort may certainly vary from person to person, depending on their reproductive health. Women may experience severe pain if their fallopian tubes are blocked. In general, some women have defined their pain as similar to cramping pains during menstruation. The pain and discomfort happening because of the procedure may usually diminish within a day or two.
2. What is the next stage if my fallopian tubes are blocked?
The next stage if the fallopian tubes are blocked may depend on the severity of the blockage. For mild blockages, your healthcare provider may suggest to perform minimally invasive procedures like hysteroscopy or laparoscopy to open or repair the tubes. In contrast, if the fallopian tubes are severely damaged or blocked, the provider may suggest fertility treatments like IVF. The IVF is suggested since the treatment can escalate the fallopian tubes to get pregnant.
3. Who performs the HSG procedure?
The Hysterosalpingogram (HSG) procedure is generally done by the gynaecologist, radiologist, or reproductive endocrinologist.
4. What are the reasons for blocked fallopian tubes?
The fallopian tubes can be damaged or blocked for several reasons. They are inflammations, infections, endometriosis, scar tissue formation, and untreated STIs (sexually transmitted infections). Blocked fallopian tubes are the common reason for infertility among women.
5. Can I get pregnant naturally even though my fallopian tubes are blocked?
The answer to the question is yes. It is somewhat possible to achieve conception naturally if one fallopian tube is blocked. But it is certainly not possible to achieve conception naturally if both of your tubes are damaged or blocked. Still, there are significant chances of conception through assisted reproductive techniques like IVF.