A hysterosalpingogram is a procedure which helps look into the shape of the uterine cavity and whether the fallopian tubes are patent or not. For the procedure, a radio-opaque dye is injected in to the cervical canal. A normal hysterosalpingogram result demonstrates filling of the uterine cavity and filling of both the fallopian tubes with the injected dye. In order to reveal a rupture of one or both the fallopian tubes, a spillage of the dye in the peritoneum has to be observed.
The procedure needs to be carried out during the follicular phase of the cycle.
This procedure is used comprehensively in the work-up of infertile women. Studies show that the chances of conceiving increases after a hysterosalpingogram. Using catheters, an interventional radiologist can open the fallopian tubes that are proximally constricted.
A hysterosalpingogram is carried out using a radiographic contrast dye which needs to be introduced into the uterus via the vagina.
If the tubes are patent, then the dye will fill the tubes and spill out into the abdominal cavity. Using this procedure, you can ascertain whether the tubes are open or occluded and whether the occlusion is situated at the junction of the tube and the uterus or at the end of the fallopian tube.
A hysterosalpingogram can be painful; hence pain killers will be given to you before and/or after the procedure to allay pain. Some doctors prescribe an antibiotic before the procedure to lessen the risk of an infection.
Role Of Hysterosalpingography In The Assessment Of Infertility
A hysterosalpingogram is a very vital investigation of the fertility potential in women; it may also serve as a therapeutic tool. The procedure is done in the radiology department of a hospital or outpatient radiology unit.
- A radio-opaque contrast medium is introduced in to the uterine cavity via the vagina.
- The uterus will fill with the contrast medium and if the fallopian tubes are patent, the dye will fill the tubes and spill into the abdominal cavity.
- This will reveal whether the fallopian tubes are open or occluded and whether the obstruction is proximal – i.e. at the intersection of the fallopian tube and the uterus or distal – i.e. at the other end of the fallopian tube.
- A normal HSG is seen as – a triangular uterine cavity and a spill out from both the fallopian tubes. In case the uterus is normal, but the tubes are blocked, there will be no dye spill at the ends of the tubes. However, such as woman can have a successful in vitro fertilization for the tubal infertility.
- If the hysterosalpingogram shows numerous filling defects in the uterus, it could be because of the presence of many endometrial polyps. Endometrial polyps need to be excised by hysteroscopic resection.
- Pregnancy rates have been reported to be slightly increased in the first months following a HSG. This has been attributed be to the sluicing out of the fallopian tubes, opening up some small occlusion or cleansing debris that was not allowing conception.
- Also, clinical trials and studies demonstrate that using oil based contrast medium gives a somewhat larger increase in pregnancy success rates than the use of water based contrast medium.