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A hysterosalpingogram (HSG) is a special imaging test, in which x-rays are used to view the inside of a woman's uterus, or womb, and fallopian tubes.

Who is a candidate for the test?

The usual purpose for a hysterosalpingogram is to determine why a woman is infertile, or unable to become pregnant.

This test may be used:

• when a woman has had multiple miscarriages
• when a woman has had pelvic inflammatory disease (PID), an infection of the female pelvic organs usually due to a sexually transmitted infection (STI)
• to check the appearance of the womb and tubes after surgery
• when a woman has abnormal or painful periods
• when a woman has abnormal uterine bleeding

How is the test performed?

A hysterosalpingogram is usually done in an x-ray department. The woman is first asked to change into a hospital gown and lie on a table. A plain x-ray picture of the pelvic area is taken. The woman is then asked to lie on her back with her feet in stirrups, just as for a pelvic exam.

The healthcare professional performing the test will then insert a speculum into the vagina, allowing him or her to see the cervix, which is the opening to the uterus (the womb). A metal clamp is gently attached to the cervix so that a thin plastic tube can be inserted into the womb.

This tube is used to inject contrast material into the womb and tubes. Contrast material is a liquid dye that shows up easily on an x-ray picture of the inside of the body. Though some women get cramps while the contrast material is injected, pain is unusual. After the contrast material is injected into the womb, pictures are taken of the womb and fallopian tubes. Then the instruments are removed and the contrast material is allowed to drain out of the vagina. A final x-ray picture is taken, after which the woman is free to get dressed and go home.

What is involved in preparation for the test?

Instructions for the hysterosalpingogram will be given by the healthcare professionals who order and perform the test. Any jewelry or metal objects that may interfere with the exam must be removed. A woman having an HSG should alert the professionals if there is a possibility of pregnancy, or if she is allergic to iodine, which is contained in most contrast material. An HSG is scheduled in advance so that a woman is not having her period on the day of the test.

What do the test results mean?

A normal hysterosalpingogram occurs when the womb and tubes appear normal and the contrast material moves freely through them.

• physical defects inside the womb or tubes that have been present since birth, also called congenital defects
• blockage in the fallopian tubes
• growths or tumors inside the womb or tubes
• inflammation in the womb or tubes
• abnormalities of the lining of the uterus or tubes, such as scarring

Other conditions may also be detected. The healthcare professional will discuss the results of the test with the woman once they are available.