A hysterosalpingogram (HSG) is a particular form of x-ray used to judge feminine fertility. It’s an outpatient process that takes now not than a half-hour. And HSG check entails inserting an iodine-based dye by means of the cervix and taking x-rays. These x-rays assist consider the form of the uterus and whether or not the fallopian tubes are blocked.
In the event you’ve had bother conceiving, an HSG is without doubt one of the first fertility checks that could be ordered. In the event you’ve had two or extra miscarriages or are experiencing secondary infertility, an HSG can be normally really useful.
Many sufferers surprise if the check will trigger ache. The reply varies from individual to individual. Some folks report gentle to reasonable cramping. Some do not feel something disagreeable throughout the check. Only a few report extreme cramping. Many say afterward that their concern of ache was a lot worse than any discomfort they felt. Moreover, varied ache drugs can be utilized, as wanted, to make the process extra snug.
Earlier than the HSG Take a look at
An HSG must be finished after your interval however earlier than ovulation. That is to scale back the danger of getting the check once you’re pregnant. Your fertility clinic or physician will advise you to name the radiology facility on day 1 of your interval to schedule the check.
The HSG is carried out if you are awake and doesn’t contain common anesthesia. You will not must quick the day or night time earlier than. Some medical doctors prescribe antibiotics to scale back the danger of an infection.
HSG Take a look at Step-by-Step
You’ll lie down on a desk, normally with stirrups. If they do not have stirrups, you would possibly must lie on the desk, bend at your knees, along with your ft (type of) flat on the desk, and maintain your legs aside.
The physician will carry out a fast pelvic examination. The technician, nurse, or physician will insert a speculum into your vagina. This is identical metallic system used throughout your yearly gynecological examination.
In the event you expertise ache throughout your annual go to, then this can be painful for you. Ladies who are suffering from sexual ache may additionally expertise ache throughout gynecological exams.
An x-ray machine will probably be lowered over your stomach. This could really feel a bit awkward, particularly with the speculum and your knees up. Subsequent, they are going to insert a swab to scrub off the cervix. That is to scale back the danger of an infection. In case your cervix is delicate to the touch, this can be a bit achy, however most girls don’t expertise ache from this.
Subsequent, they are going to insert a plastic catheter known as a cannula into the cervical opening. This feels form of like a pap smear and is perhaps slightly uncomfortable. Or, you could not really feel something.
Lastly, an iodine-based dye will probably be injected by means of the catheter. When the dye is injected, you could really feel a warming sensation. This dye will undergo your uterus, by means of the fallopian tubes (if they’re open), and spill out into the pelvic cavity.
In case your tubes are blocked, you could expertise discomfort when the dye is injected. Inform your physician straight away when you start to turn out to be uncomfortable.
After injecting the dye, your physician will take the x-rays. For every x-ray image, you may be requested to carry your breath for a second or two. Chances are you’ll be requested to alter your place. For instance, you could be requested to lie in your aspect. Chances are you’ll really feel uncomfortable with the speculum inside and the x-ray over you. Your physician understands. Ask for assist when you want it.
As soon as the physician has determined that the photographs are passable, the x-ray machine will probably be lifted up and the speculum eliminated. You are free to go dwelling.
Managing HSG Take a look at Discomfort
The check will be nerve-wracking, with this huge x-ray machine hovering over you whilst you’re mendacity in your again, legs aside, with the speculum inside. The nurse or physician could ask you to roll over to your aspect for an x-ray or two, and it’s a must to do it with the speculum nonetheless between your legs.
In most pregnant folks, the dye painlessly passes by means of the uterus, by means of the fallopian tubes, and out into the belly cavity. Nevertheless, in case your tubes are blocked, the dye could cause stress, inflicting substantial discomfort. In the event you do really feel intense ache, inform your physician straight away. They will shortly take away the catheter, which is able to launch the stress and may remove your ache.
On the day of the check, your physician could recommend taking a painkiller like ibuprofen an hour earlier than your HSG is scheduled, or you could determine to take it afterwards. This may also help with the discomfort of the check. Most medical doctors advocate taking ibuprofen an hour earlier than the HSG. This could cut back gentle cramping throughout the check. Nervousness and concern concerning the check can enhance your notion of ache.
After the Take a look at
Chances are you’ll expertise gentle cramps and lightweight recognizing. Over-the-counter ache relievers ought to assist with cramps. You can resume common exercise after the check. Some medical doctors could inform you to chorus from sexual activity for a number of days after the check.
Whereas gentle cramps are regular, in case your discomfort appears to be rising after the check otherwise you develop a fever, contact your physician. There’s a uncommon threat of an infection following an HSG. Rising ache could also be an indication of an infection.
There’s a uncommon threat of an infection following an HSG. Rising ache could trace that an an infection is growing.
What HSG Take a look at Outcomes Imply
After your check, your supplier will ship your check outcomes. The HSG helps the physician take a look at two essential components:
Are the Fallopian Tubes Open?
If the fallopian tubes are blocked, the egg cannot meet the sperm and conception will not be doable. There are a number of potential causes and corresponding remedies if that is so.
Are There Any Uterine Abnormalities?
In some girls with recurrent being pregnant loss, an abnormally formed uterus is responsible. An HSG check may present fibroids or polyps that might get in the way in which of an embryo implanting and/or rising. Some uterine abnormalities will be handled with surgical procedure.
If the x-ray exhibits a standard uterine form, and the injected dye spills freely out from the ends of the fallopian tube, then the check outcomes are thought of regular. This does not, nonetheless, imply your fertility is regular. It simply means no matter could also be mistaken wasn’t seen on the HSG.
Hormonal-based causes of infertility is not going to be seen on an HSG. Not all uterine-based fertility issues will be visualized with an HSG.
One small examine discovered a 35% incident of false negatives with an HSG. In different phrases, the HSG confirmed a standard uterine form, however a hysteroscopy confirmed abnormalities. (Hysteroscopy entails inserting a skinny, telescope-like digicam by means of the cervix to take a look at the within of the uterus.)
Additionally, endometriosis cannot be identified with an HSG. Solely an exploratory laparoscopy can rule out or diagnose endometriosis.
If the dye exhibits an abnormally formed uterus, or if the dye doesn’t circulation freely from the fallopian tubes, there could also be an issue.
It is essential to know that 15% of ladies have a “false optimistic.” That is when the dye does not get previous the uterus and into the tubes. The blockage seems to be proper the place the fallopian tube and uterus meet. If this occurs, the physician could repeat the check one other time or order a unique check to verify.
An HSG can present that the tubes are blocked, however it may well’t clarify why. Your physician could order additional testing, together with exploratory laparoscopy or hysteroscopy. These procedures can each assist examine the difficulty and presumably right the issue.
HSG Take a look at Dangers and Security Considerations
An HSG is a typically protected process. Nonetheless, there are some security issues and potential dangers of an HSG check.
An infection could happen in lower than 1% of instances. That is extra frequent when you’ve already had an an infection otherwise you’re in danger for pelvic inflammatory illness (PID). In the event you expertise fever or rising ache after the check, name your physician. In case you have a historical past of PID, sexually transmitted an infection, or belly surgical procedure (resembling an appendectomy), your physician could prescribe antibiotics for the process as an additional precaution.
One other threat is fainting throughout or after the check. In the event you really feel dizzy after the examination, inform your physician. It could be higher so that you can stay mendacity down till you’re feeling much less woozy.
A uncommon however probably severe threat is iodine allergy. If you’re allergic to iodine or shellfish, inform your physician earlier than the check. In case you have any itching or swelling after the check, inform your physician.
Often, when you’ve got an x-ray, the very first thing the technician does is canopy your pelvic space. Throughout an HSG, the x-ray is aimed proper on the pelvis. Be reassured that an HSG entails a really low quantity of radiation. It has not been discovered to trigger any negative effects, even when you get pregnant later that cycle.
Nevertheless, an HSG ought to not be finished throughout being pregnant. In the event you assume you could be pregnant, inform your physician earlier than you’ve got the check.
A Phrase From Verywell
It is comprehensible to really feel nervous earlier than and through an HSG examination. Deep, relaxed respiratory by means of the process may also help. Additionally, do not be afraid to inform the nurse or physician that you just’re nervous or in ache. The nurse could even provide to carry your hand, which actually may also help you’re feeling higher.
Total, the process is fast, and for some, it is fully painless. In the event you do really feel ache, normally, it is short-lived and lightweight. Alert your physician if this is not the case, and they’re going to take fast steps to alleviate stress and ache as shortly as doable. Earlier than your examination, additionally ask in case your physician recommends taking a painkiller.