Trying to get pregnant?

If you are trying to get pregnant and things aren’t going quite as planned, you may want to talk to your doctor and discuss about fertility evaluation, which can include a hysterosalpingogram, also called hysterosalpingography (HSG).

What is an HSG?

An HSG is an examination used to see if your fallopian tubes are open (patent) and if the uterine cavity is normal. A clear fluid called contrast medium is slowly infused into your uterus and tubes while images are taken using x-rays.

Why check the fallopian tubes?

Tubal blockages can stop sperm from reaching the egg and prevent fertilisation. At least one patent tube is needed for fertilisation.

Why check the uterine cavity?

Uterine conditions such as polyps, fibroids, adhesions, abnormalities of shape etc. may also lead to fertility issues.

What is the contrast fluid used during an HSG?

The contrast used during an HSG is an iodine-based fluid that can be seen on x-ray and so makes your uterus and fallopian tubes visible. Two types of contrast fluids can be used: oil- or water-based. Talk with your doctor to learn more about these contrast media.

 Can an HSG help me get pregnant?

There is scientific evidence to suggest that in some women there is an increase in pregnancy and conception rates following an HSG. During infertility work-up a higher rate of pregnancy has been observed in women undergoing HSG with oil-based contrast fluid, compared to women who did not undergo HSG or who underwent HSG with water-soluble contrast fluid.

When to perform an HSG?

An HSG is performed after your menstrual period and before ovulation (ideally before the 12th day of the menstrual cycle for women with a regular cycle of 28 days).

The timing ensures that you are not pregnant when undergoing HSG.

Your doctor may also advise avoiding intercourse from the first day of your menstrual cycle until the HSG and/or perform a pregnancy test before the procedure.


What happens during an HSG?


  • You will be positioned on the x-ray table and bring your legs up into a gynaecological position
  • A speculum will be gently inserted
  • The cervix will be cleansed

Information: In a majority of cases, an HSG does not involve anesthesia.


The examination is usually done in less than 15 minutes. You may expect to be around for about 30 minutes with the preparation time.

  1. A thin plastic tube (called a catheter) is passed into the cervix
  2. The contrast fluid is slowly infused through the thin tube into your uterus
  3. The progress of the contrast fluid is followed with the x-ray machine and images are taken
  4. Instruments are gently removed

Information: In some cases, you may be asked to rest and wait in the radiology department for 30 minutes to obtain a delayed image.



What are the contraindications to an HSG?

An HSG must not be performed during pregnancy or if you have an acute pelvic infection. The examination is also contraindicated in case of recent haemorrhage or bleeding, recent pelvic surgery, traumatic injuries, or known hyperthyroidism. Inform your doctor if you have previously experienced an allergic reaction to an iodinated contrast fluid.

What are the benefits of an HSG?

An HSG is a simple and noninvasive procedure providing useful information about your uterine cavity and fallopian tubes. The results of the examination, combined with the other fertility tests you are undergoing, will help your doctor to select the best treatment option for you. In some cases, an HSG may help you become pregnant.

How should I prepare?

Tell your physician about any other health concerns, recent pelvic infections and about any medication you are currently taking. You may be screened for infections such as Chlamydia. In some cases, you may be advised to take an antibiotic before or after the procedure.

What will I experience during and after the procedure?

You may experience some crampy, period-like discomfort during the HSG. If discomfort persists after the examination, this can be relieved by simple analgesia. After the examination, you will likely have a little vaginal bleeding and leakage of the contrast fluid, which is a sticky clear liquid: a sanitary pad is recommended. Any discomfort or spotting should subside within one to two days.

Are there any side effects?

An HSG is a well-tolerated procedure but occasionally side effects may occur. The most common side effects include infection, pain, fainting and allergy to the contrast fluid. Please consult your physician immediately if you have any concerns or if you experience a fever, an offensive discharge, persistent pain or persistent bleeding.

What about radiation?

The radiation amount from an HSG is very low (typically less than a chest x-ray), the exposure has not been shown to cause any harm. No radiation remains in your body after the examination.