Hysterosalpingogram

The purpose of the HSG is to check for obstructions or growths within your uterus and fallopian tubes. Conditions such as blocked fallopian tubes, fibroids, and adhesions may be diagnosed during the HSG procedure. Your doctor may recommend that you undergo an HSG if he or she suspects that you have an abnormality within your uterus or fallopian tubes.

The HSG is performed shortly after you have completed your monthly period bleeding. The procedure is usually carried out in a hospital or an outpatient setting where x-ray equipment is available. Some large and well-equipped fertility offices may have this equipment on-site. For the procedure itself, you are placed in the same position as for a Pap test. The doctor places a thin tube into your vagina and threads it up into your cervix. A fluid dye is injected through the tubing while an x-ray of your pelvis is performed. X-ray images follow the contours of your pelvic organs as the dye fills your uterus and up into your fallopian tubes.

You may experience discomfort and cramping during the procedure, so you may wish to take pain medication in advance.

After the HSG, you may have minor cramps and discomfort for a few days. It is also normal to have slight vaginal discharge. Your doctor may recommend that you continue pain medication to minimize your discomfort. You may also be given a prescription for antibiotics, if your medical history indicates that you are at increased risk for infection. The antibiotics are a preventive measure to reduce the chance of developing a pelvic infection from the HSG procedure itself. Risks and complications with the HSG procedure are rare. However, be sure to call your doctor if you experience heavy bleeding or extreme discomfort or cramping pain.

Your doctor will discuss your HSG test results with you. If uterine fibroids are noted, they may or may not require treatment, depending on their size and position within your uterus. Blocked fallopian tubes are a fairly common finding among infertility patients. It has been estimated that almost 35 percent of infertility cases are due to blockage of one or both fallopian tubes. If this is your situation, your doctor will discuss treatment options. (See Chapter 1 for more information.)

A shortcoming of the HSG procedure is that it may not detect small lesions such as small polyps or fibroids within the uterus. It also does not provide any information whatsoever regarding the ovaries. On the positive side, a 2002 New Zealand study conducted at the University of Auckland showed an increase in conception rate in the months following the HSG procedure. This is thought to be due to the fluid dye pumped through the uterus and fallopian tubes during the HSG. This flushing of fluid may open and clear the passageway for the sperm and the egg to pass through and move about more easily.

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