Understanding Hysterosalpingography in IVF: A Key Diagnostic Tool

by Athanasios Pantelis, last updated 29 Jul 2024,

4 min read

When it comes to fertility treatments, understanding the health of your reproductive system is crucial. One of the essential diagnostic tools used in the journey towards successful in vitro fertilization (IVF) is salpingography, specifically hysterosalpingography (HSG). This procedure helps doctors assess the condition of your fallopian tubes and uterus, providing valuable insights that can guide your treatment plan.

What is Hysterosalpingography (HSG)?

Hysterosalpingography, often abbreviated as HSG, is a specialized X-ray procedure used to examine the inside of the uterus and fallopian tubes. By injecting a contrast dye through the cervix, doctors can visualize the shape and patency (openness) of these structures on an X-ray. This test is particularly important for identifying blockages or abnormalities that might be preventing pregnancy.

Why is HSG Important in IVF?

For women undergoing IVF, knowing the status of the fallopian tubes is essential. Although IVF bypasses the need for open fallopian tubes by fertilizing the egg outside the body, understanding any underlying issues can still impact the overall treatment strategy. Here’s why HSG is a critical step:

  • Identifying Blockages: Blocked fallopian tubes can prevent sperm from reaching the egg naturally. HSG helps detect such blockages, which might necessitate alternative treatment approaches.
  • Assessing Uterine Health: The procedure also reveals abnormalities in the uterus, such as fibroids, polyps, or structural issues, which could affect embryo implantation and pregnancy.
  • Guiding Treatment Plans: The results of an HSG can help doctors decide whether additional procedures, like laparoscopy, are needed or if IVF is the best course of action.

How is the HSG Procedure Performed?

The HSG procedure is relatively straightforward and typically takes about 30 minutes. Here’s what you can expect:

  • Preparation: The procedure is scheduled after your menstrual period but before ovulation to ensure you are not pregnant. You might be advised to take a pain reliever beforehand to minimize discomfort.
  • Injection of Contrast Dye: A thin catheter is inserted through the vagina into the uterus. A contrast dye is then injected, filling the uterus and fallopian tubes.
  • X-ray Imaging: As the dye spreads, X-ray images are taken to visualize the internal structures. If the dye flows freely through the fallopian tubes and spills into the abdominal cavity, it indicates that the tubes are open.
  • Post-Procedure: You may experience mild cramping and spotting after the procedure, but these symptoms usually resolve quickly. Most women can resume normal activities the next day.

What Do the Results Mean?

The results of an HSG can provide significant insights into your fertility:

  • Normal Results: If the dye passes through the fallopian tubes without obstruction, it suggests that the tubes are open, and there are no significant abnormalities in the uterus.
  • Abnormal Results: Blockages, structural abnormalities, or other issues may be detected. In such cases, your doctor will discuss the next steps, which might include further diagnostic tests or proceeding with IVF.

The Role of HSG in Enhancing Fertility

Interestingly, some studies suggest that the HSG procedure itself might have a therapeutic benefit. The process of flushing the fallopian tubes with the contrast dye can sometimes clear minor blockages, potentially improving fertility in the months following the test. However, more research is needed to fully understand this effect.

Preparing for Your HSG

To ensure the best possible experience and results, here are a few tips for preparing for your HSG:

  • Schedule Wisely: Plan the procedure for after your period but before ovulation.
  • Follow Doctor’s Instructions: Take any prescribed medications and follow pre-procedure guidelines.
  • Relax and Ask Questions: Understanding the procedure can help alleviate anxiety. Don’t hesitate to ask your doctor any questions you might have.



An alternative way to investigate the patency of the fallopian tubes is the HyCoSy technique, which we can evaluate in detail the structure of the endometrial cavity, avoiding a hysteroscopy. During this non-invasive procedure, saline or contrast media is injected into endometrial cavity using a special catheter. This then allows us to evaluate any abnormality in the endometrial cavity using a transvaginal ultrasound probe.
Using the same procedure the patency of the fallopian tubes can be examined, avoiding the necessity of a hysterosalpingogram.

Conclusion

Hysterosalpingography is a valuable diagnostic tool in the IVF process, providing crucial information about the health of your fallopian tubes and uterus. By identifying potential issues early on, HSG helps tailor your fertility treatment plan, increasing the chances of a successful pregnancy. At Newlife IVF Greece, we are committed to supporting you every step of the way, ensuring you have the best possible care and guidance on your fertility journey.

For more information and to schedule your free medical consultation, visit our website or contact our clinic today. Your path to parenthood starts here.

Athanasios Pantelis

Athanasios Pantelis, MD, PhD

Athanasios is an Infertility Specialist at Newlife IVF Greece. He obtained a PhD degree and graduated from the Medical School of the Aristotle University of Thessaloniki (AUTH).

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