Infertility & Reproduction Health Center

A hysterosalpingogram (HSG) is an X-ray test that looks at the inside of the uterus and fallopian tubes and the area around them. It often is done for women who are having a hard time becoming pregnant (infertile).

During a hysterosalpingogram, a dye (contrast material) is put through a thin tube that is put through the vagina and into the uterus. Because the uterus and the fallopian tubes are hooked together, the dye will flow into the fallopian tubes. Pictures are taken using a steady beam of X-ray (fluoroscopy) as the dye passes through the uterus and fallopian tubes. The pictures can show problems such as an injury or abnormal structure of the uterus or fallopian tubes, or a blockage that would prevent an egg moving through a fallopian tube to the uterus. A blockage also could prevent sperm from moving into a fallopian tube and joining (fertilizing) an egg. A hysterosalpingogram also may find problems on the inside of the uterus that prevent a fertilized egg from attaching (implanting) to the uterine wall. See a picture of a hysterosalpingogram.

Why It Is Done

A hysterosalpingogram is done to:

• Find a blocked fallopian tube. The test often is done for a woman who is having a hard time becoming pregnant. An infection may cause severe scarring of the fallopian tubes and block the tubes, preventing pregnancy. Occasionally the dye used during a hysterosalpingogram will push through and open a blocked tube.
• Find problems in the uterus, such as an abnormal shape or structure, an injury, polyps, fibroids, adhesions, or a foreign object in the uterus. These types of problems may cause painful menstrual periods or repeated miscarriages.
• See whether surgery to reverse a tubal ligation has been successful.

How To Prepare

Before a hysterosalpingogram, tell your doctor if you:

• Are or might be pregnant.
• Currently have a pelvic infection (pelvic inflammatory disease) or sexually transmitted disease (such as gonorrhea or chlamydia).
• Are allergic to the iodine dye used or any other substance that has iodine. Also tell your doctor if you have asthma, are allergic to any medicines, or have had a serious allergic reaction (anaphylaxis) from any substance (such as the venom from a bee sting or from eating shellfish).
• Have any bleeding problems or are taking any blood-thinning medicines, such as aspirin or warfarin (such as Coumadin).
• Have a history of kidney problems or diabetes, especially if you take metformin (such as Glucophage) to control your diabetes. The dye used during a hysterosalpingogram can cause kidney damage in people with poor kidney function. If you have a history of kidney problems, blood tests (creatinine, blood urea nitrogen) may be done before the hysterosalpingogram to check that your kidneys are working well.