Hysterosalpingography (HSG)

Hysterosalpingography (HSG)

 

Hysterosalpingography (HSG) is a radiological procedure used to examine the uterus and fallopian tubes. It involves the injection of a radiopaque substance containing iodine through the cervix into the uterine cavity and fallopian tubes before taking X-ray images. The purpose of this procedure is to visualize the shape and patency of the uterus and fallopian tubes and detect any abnormalities that may cause infertility or tubal obstruction, such as tubal blockages or uterine abnormalities.

 

How to prepare for the procedure?

Since there may be some discomfort or cramping during the injection of the dye due to the pressure within the uterus, it is recommended to take a nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen (Brufen) 400-600 milligrams one hour before the procedure.

 

When is the best time to have the procedure?

The ideal time for HSG is 7-12 days after the last menstrual cycle, counting the first day of menstruation as day one. It is important to ensure that you are not pregnant at the time of the procedure.

 

It is also advised to avoid sexual intercourse from the last day of menstruation until the day of the procedure.

 

The examination process:

The doctor will have us lie down like a regular check-up and insert a tool to open the birth canal, then clean the cervix with medication. After that, the doctor will insert a small tube into the cervix and take an X-ray to examine the flow of color. If the test results are normal, it will only take about 10 minutes to complete.

 

Side effects:

1. Spotting or light bleeding which usually stops on its own within 24 hours.
2. Infection may occur, causing fever and foul-smelling discharge 2-4 days after the test. However, the risk is low because all tools are sterilized.
3. Mild cramping may occur in patients with a history of ovarian tubes. It is usually brief and not severe.
4. Allergic reactions to the radiation exposure are rare.

 

How many types of radiopaque substances are there?

There are two types of radiopaque substances used in HSG: water-soluble and oil-based. Several studies have compared the pregnancy rates during HSG using water-soluble and oil-based radiopaque substances and found that oil-based substances can increase the chance of pregnancy by up to 10%.

 

There are several reasons why oil-based radiopaque substances may improve pregnancy rates:

 

1. Oil-based substances can help flush out debris and small blockages in the fallopian tubes and create a better environment for sperm and eggs to meet.

 

2. Oil-based substances can reduce the number of immune cells (macrophages) that may attack and destroy sperm and eggs, increasing the chance of successful fertilization. The properties of oil-based radiopaque substances can reduce the number of immune cells, which may protect the body from foreign invaders.

 

3. Oil-based substances can increase the number of uterine natural killer cells, which are important for preparing the uterus for pregnancy.

 

Best wishes from the Obstetrics and Gynecology Department, Vibhavadi Hospital