Infertility Testing

Hysterosalpingogram (HSG) is an X-ray test that examines the inside of uterus and fallopian tubes and the surrounding area. It often is done for women who are unable to become pregnant (infertile).

During a hysterosalpingogram, a dye called contrast material is injected through a thin tube that is inserted through the vagina into the uterus. Because the uterus and the fallopian tubes are connected, the contrast material will flow into the fallopian tubes. As the contrast material passes through the uterus and fallopian tubes, continuous X-ray pictures are taken. The pictures can reveal problems such as an injury or abnormal structure of the uterus or fallopian tubes, or blockage that would prevent an egg passing through a fallopian tube from reaching the uterus. Blockage also could prevent sperm from traveling into a fallopian tube and fertilizing an egg. A hysterosalpingogram also may detect abnormalities on the inside of the uterus that might prevent a fertilized egg from attaching (implanting) to the uterine wall.

Why is it Done?

A hysterosalpingogram is done to:

Detect a blocked fallopian tube. The test often is done for a woman who is having difficulty becoming pregnant. An infection that causes severe scarring of the fallopian tubes can block the tubes, preventing pregnancy. Occasionally a hysterosalpingogram will open a blocked tube.

Identify problems of the uterus, such as an abnormal shape or structure, an injury, polyps, fibroids, adhesions, or a foreign object in the uterus. These types of problems may cause painful menstrual periods or repeated miscarriages.

Determine whether surgery to reverse a tubal ligation has been successful

Determine the success of a tubal ligation, if there is a question about the success of this surgery. However, this is rare

What to Expect?

This test should be done 2 to 5 days after your menstrual period has ended to be sure you are not pregnant. It should also be done before you ovulate (unless you are using contraception) to avoid the possibility of using X-rays during an early pregnancy. You may want to bring along a sanitary napkin to wear after the test because some leakage of the X-ray contrast material may occur along with slight bleeding. Things to tell us before we begin:

  • Are or moght be pregnant
  • If you are alergic to iodine
  • If you have any bleeding problems or are taking blood thinning medications
  • Having a history of kidney problems or you are a diabetic


There is always a slight risk of damage to cells or tissue from being exposed to any radiation, including the low levels of radiation used for this test. However, the risk of damage from the X-rays is usually very low compared with the potential benefits of the test. There are precautions you can take to reduce your risk of radiation exposure from X-rays.

There is some risk (less than 1 in 100) of a pelvic infection, endometritis, or salpingitis following this test. The risk may be higher for women who have had previous pelvic infections. Your health professional may prescribe antibiotics if he or she considers you at risk for a pelvic infection.

There is some risk of damaging or puncturing the uterus or fallopian tubes.

The use of oil-soluble contrast material has a very slight risk of introducing oil droplets into the bloodstream. This can cause blockage of blood flow to a section of the lung (pulmonary embolism), a very serious condition. Most diagnostic hysterosalpingogram tests are performed with water-soluble contrast material.


A hysterosalpingogram (HSG) is an X-ray test that examines the inside of uterus and fallopian tubes and the surrounding area.

The shape of the uterus and fallopian tubes are normal. The fallopian tubes are not scarred or damaged. The contrast material does not leak out of the uterus, flows freely through the fallopian tubes, and spills into the abdomen. Fallopian tubes may be scarred, malformed, or blocked so that the contrast material does not flow smoothly through the tubes and out into the abdomen. Possible causes of blocked fallopian tubes include pelvic inflammatory disease (PID) or endometriosis.
No objects (such as an intrauterine device, IUD), tumors, or abnormal growths can be seen in the uterus. The contrast material may leak through the wall of the uterus, indicating a tear or hole in the uterus.
An abnormal uterine cavity may reveal tissue (called a septum) that divides the uterus.
Abnormal growths (such as polyps or fibroids) may be present.

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