Hysterosalpingogram (HSG)

Your doctor has requested that you have a hysterosalpingogram. We hope the following information will answer some of the questions you may have about this procedure.

What is a hysterosalpingogram (HSG) and why do I need one?

A HSG is a special x-ray examination which looks at the inside of your uterus (womb) and fallopian tubes. It aims to show whether your uterus is normal and if your fallopian tubes are damaged, swollen, blocked or if there are any adhesions around the tubes.

It may explain why you have not been able to get pregnant and it will help your doctor decide the most appropriate treatment for you.

This test is only effective if carried out at very specific times, and therefore it is important that you read the information in this leaflet carefully.

How do I arrange my appointment?

We perform this examination within 10 days of the start of your period. The best time is between day 5 and day 10.

Please telephone us on the first day of your period (the first day that you have any spotting or bleeding). The phone number can be found on your appointment letter. Should you start your period over a weekend, please contact us as soon as you can on Monday morning and we will try our best to give you an appointment within the 10 days as above. 

Should you not have regular periods please telephone for advice.

Should you be bleeding heavily the day before your examination, please also telephone for advice.

If there is the slightest chance that you could be pregnant, we will not perform the examination as x-rays could put your pregnancy at risk. For this reason, DO NOT have unprotected sexual intercourse from the first day of your period until after the procedure. We will also perform a pregnancy test before the examination is carried out.

On the day of the procedure

You will arrive at Gate 18 whereby a member of the Imaging team will take you to the fluoroscopy waiting room where your details will be checked.

You will be asked about your last period, whether you have followed the instructions regarding sexual intercourse, whether you have taken any pain relief, if you have allergies, and if you have been given a prescription for antibiotics.

The procedure will be explained and a pregnancy test will be performed – please do not empty your bladder before you are called as you will need to provide a urine sample for this. 

You will be asked to undress and put a gown on. 

You will then be taken into the x-ray room for the procedure.

What does the examination involve?

You will be asked to lie down on the x-ray table in a similar position to that used for a smear test. An instrument called a speculum will be inserted into your vagina (as in a smear test). A fine tube is inserted through the cervix into the neck of the uterus and held in position with a small balloon. 

A small amount of colourless dye is then injected into the uterus and fallopian tubes. This dye is visible on x-ray so images will be taken at this time.

The examination normally takes 10 minutes but sometimes may take a little longer – you should allow for 30 minutes which includes time to change into your gown, the test itself, and changing afterwards.

Is the examination painful?

You may experience some mild to moderate discomfort, rather like a bad period pain, as the dye fills your uterus and fallopian tubes. This discomfort should settle as soon as the test is finished.

As you may feel some discomfort we advise you to take some over the counter painkillers within the 2 hours before your procedure. This can be what you may usually take for period pains, for example paracetamol or ibuprofen. You may also need to take a further dose of painkillers 4 hours after your HSG.

You may wish to bring someone with you in case you are in any discomfort after the procedure, or to drive you home. Most people feel absolutely fine after the test, and often express how much better the test was than anticipated.

What happens after the procedure?

You will be given a sanitary towel after the procedure as there may be some slight spotting, and some of the dye will trickle out over the next 24 hours. (The dye is colourless but a little sticky). We advise you not to use tampons.

You are free to leave the department when you feel ready – as above, this will be after approximately 30 minutes.

If you have any problems with bleeding or offensive discharge after your test, or if you have severe pain which is not relieved by paracetamol or ibuprofen, please contact either the Fertility Clinic or your GP for an urgent review appointment.

Your results will be discussed with you when you next see your referring consultant or your GP. If you do not already have an appointment, please make one.

What are the risks?

The staff will make the test as safe as possible. However, complications can happen:

  • There is a small risk of infection. Your referring doctor may have prescribed a course of antibiotics to take before the procedure. 
  • There is an extremely rare possibility of an allergic reaction to the x-ray dye. It is important to let the person who is doing the test know if you have any known allergies.
  • Occasionally some patients feel ‘faint’ after the test. Should you feel faint we will ask you to remain in the room until you feel better.

Finally, we hope this information is helpful.  If you have any questions either before or after the procedure the staff in the Imaging department will be happy to answer them.  

The telephone number for the Imaging department can be found on your appointment letter.

How to contact us:

Gate 18 - Brunel building
Southmead Hospital
Westbury-on-Trym
Bristol
BS10 5NB

Please see the number on your appointment letter

www.nbt.nhs.uk/

If you or the individual you are caring for need support reading this leaflet please ask a member of staff for advice.

© North Bristol NHS Trust. This edition published January 2020. Review due January 2022. NBT003249

Hysterosalpingogram (HSG)