The test can be nerve-wracking, with this big x-ray machine hovering over you while you're lying on your back, legs apart, with the speculum inside. The nurse or doctor may ask you to roll over to your side for an x-ray or two, and you have to do it with the speculum still between your legs.
In most women, the dye painlessly passes through the uterus, through the fallopian tubes , and out into the abdominal cavity. However, if your tubes are blocked, the dye can cause pressure. This is what can then lead to substantial discomfort or even pain. The good news is that if you do feel intense pain, it shouldn't last for more than a minute. During the test, if you feel pain, tell your doctor right away. They can quickly remove the catheter, which will release the pressure and should eliminate your pain.
Most doctors recommend taking ibuprofen an hour before the HSG. This can reduce mild cramping during the test. Anxiety and fear about the test can increase your perception of pain. You may experience mild cramps and light spotting. You'll be able to resume regular activity after the test. Some doctors may tell you to refrain from sexual intercourse for a few days after the test.
While mild cramps are normal, if your discomfort seems to be increasing after the test or you develop a fever, contact your doctor. There is a rare risk of infection following an HSG.
Increasing pain may be a sign of infection. Increasing pain may hint that an infection is brewing. After your test, your provider will deliver your test results. The HSG helps the doctor check out two important factors:. If the x-ray shows a normal uterine shape, and the injected dye spills freely out from the ends of the fallopian tube, then the test results are considered normal.
This doesn't, however, mean your fertility is normal. It just means whatever may be wrong wasn't seen on the HSG. Hormonal-based causes of infertility will not be seen on an HSG. Not all uterine based fertility problems can be visualized with an HSG. In other words, the HSG showed a normal uterine shape, but a hysteroscopy showed abnormalities.
Also, endometriosis can't be diagnosed with an HSG. Only an exploratory laparoscopy can rule out or diagnose endometriosis. If the dye shows an abnormally shaped uterus, or if the dye does not flow freely from the fallopian tubes, there may be a problem. The blockage appears to be right where the fallopian tube and uterus meet. If this happens, the doctor may repeat the test another time or order a different test to confirm.
An HSG can show that the tubes are blocked, but it can't explain why. Your doctor may order further testing, including exploratory laparoscopy or a hysteroscopy. These procedures can both help investigate the issue and possibly correct the problem. An HSG is a generally safe procedure. Still, there many people are concerned about safety and potential risks of an HSG test. This is more common if you've already had an infection or you're at risk for pelvic inflammatory disease PID.
HSG is an outpatient procedure that usually takes less than 5 minutes to perform. It is usually done after the menstrual period ends but before ovulation. A woman is positioned under a fluoroscope a x-ray imager that can take pictures during the study on a table. Her cervix is cleaned, and a device cannula is placed into the opening of the cervix. The doctor gently fills the uterus with a liquid containing iodine a fluid that can be seen by x-ray through the cannula.
The contrast will be seen as white on the image and can show the contour of the uterus as the liquid travels from the cannula, into the uterus, and through the fallopian tubes. As the contrast enters the tubes, it outlines the length of the tubes and spills out their ends if they are open.
An HSG is done for women who are having a hard time getting pregnant or who have had repeated miscarriages. The test will take about 15 to 30 minutes.
Call your doctor or nurse call line now or seek immediate medical care if:. Watch closely for changes in your health, and be sure to contact your doctor or nurse call line if you have any problems. Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse call line if you are having problems. It's also a good idea to keep a list of the medicines you take.
Ask your doctor when you can expect to have your test results. Author: Healthwise Staff. Care instructions adapted under license by your healthcare professional. If you have questions about a medical condition or this instruction, always ask your healthcare professional.
Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated. It looks like your browser does not have JavaScript enabled. Please turn on JavaScript and try again. It can also make sure the cavity is not affected by fibroids, polyps or scar tissue. Prior to starting the HSG, the patient must produce a urine sample.
This is an important step as it allows the practitioner to be sure that the patient is not unknowingly pregnant prior to starting the HSG. Should a patient be pregnant, the contrast used to fill the uterus can harm or displace the growing fetus, resulting in an increased risk of miscarriage.
At the start of the procedure, a speculum is inserted into the vagina in order to view the cervix, similar to a Pap smear. The cervix is cleaned with an antiseptic solution; then, a thin, plastic catheter, generally about the size of the tip of a pen, is placed inside the cervix. Once placed, a small amount of contrast, usually two to three teaspoons, is passed through the catheter into the cervix, filling the uterus and fallopian tubes.
Contrast is used, as opposed to dye, which is a colored substance that cannot be seen on an x-ray, whereas contrast can. The tubes are considered open when the contrast is able to move completely through the length of the tube, spilling the contrast out on the other side.
Immediately following the HSG test, patients will receive preliminary results from their practitioner. When spotting or discharge occurs, we encourage patients to use sanitary napkins or pads as opposed to tampons. We also encourage our patients to speak with their physician about taking some over-the-counter pain reliever following the test to reducing any cramps or discomfort. While uncommon, a risk associated with HSG is infection.
Patients that have a diagnosed or suspected problem with their fallopian tubes — such as a history of ectopic pregnancies or a hydrosalpinx — will likely be prescribed an antibiotic to be taken in advance. An HSG will not bring on menses, so if you experience a full menstrual flow, develop a fever, or continue to feel pain for more than a few days, you should speak with your physician.
Shady Grove Fertility places high value on patient safety and comfort and goes out of our way to minimize discomfort. Many women feel some cramping for about 2 minutes when the contrast is filling the uterus. Therefore, we strongly encourage taking an over-the-counter pain reliever such as ibuprofen 30 to 60 minutes before the test to reduce feelings of pain or discomfort.
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