Hysterosalpingography (HSG) – testing the patency of the fallopian tubes

HSG - what is it?

HSG (hysterosalpingography) is one of the basic tests used in the diagnosis of infertility. The test involves injecting a special liquid into the uterine cavity and taking a series of radiographs. HSG is an invasive test - it consists in intravaginal introduction of a special, contrasting agent into the fallopian tubes and uterus, which enables obtaining a very accurate image.
Fallopian tubes patency is increasingly being assessed using more modern ultrasonography instead of X-rays.
The HSG test enables:

• assessment of the shape of the uterus,
• diagnosis of changes in the structure of the uterus - malformations of the uterus, such as tumors or other changes,
• examination of the patency of the fallopian tubes and their shape,
• detect
• the presence of adhesions, polyps, submucosal fibroids.
  
  

When to perform an HSG test?

The HSG test is performed after the end of menstruation, in the first phase of the cycle.
If you are taking birth control pills, the test can be performed any day after the bleeding has stopped.

What role do the fallopian tubes play?

The function of the fallopian tubes is:

• allowing sperm to be transported to the egg cell,
• creating the right conditions for fertilization of this cell,
• development of the resulting embryo and its transport to the uterine cavity.

These processes can occur due to complex contractions, the presence of secretions produced by the glands of the fallopian tubes and the movements of the micro-cilia lining their lumen. HSG allows to assess the patency of the fallopian tubes, but it does not allow for a precise assessment of their functioning.

What can cause obstruction of the fallopian tubes?

• Reducing or closing the lumen of the fallopian tubes by the formation of mucus plugs.
• Inflammation causing adhesions.
• Infections and sexually transmitted diseases.
• Past surgeries in the area of the abdominal cavity.
• Infections of the reproductive tract appearing as a result of miscarriage.
• Endometriosis.
  
  

HSG - preparation for the examination

The referral for the examination is issued by a gynecologist. Before the examination, a consultation is necessary, during which the doctor will discuss the course of the examination itself and order pharmacological preparation for the procedure. If, after consulting a doctor, the patient decides to perform the examination under short-term general anesthesia, she should additionally perform a set of examinations required before anesthesia.

On the day of the examination, the patient comes to the clinic about 1h-30 minutes before the planned procedure. If the examination is to take place under general anesthesia, the patient must refrain from eating and drinking 6 hours before the procedure. Patients undergoing general anesthesia cannot drive motor vehicles on the day of the examination.

Pain resulting from the HSG examination is a very individual matter - some women undergo the procedure completely painlessly and without major inconvenience, others who have a lowered pain threshold can always benefit from a short intravenous general anaesthesia.

Tubal patency testing and pregnancy – are there any contraindications to HSG?

Due to the invasive nature of the examination, there are some contraindications to hysterosalpingography. Certain medical conditions may prevent the correct reading of the image. Contraindications include:

• pregnancy,
• active inflammatory process in the reproductive organs
• vaginal bleeding,
• contraindications for contrast administration in the case of the traditional method using the X-ray technique