This information leaflet has been produced to give you general information and hopes to answer most of your questions when requiring a Hysterosalpingogram (HSG). It is not intended to replace the discussion between you and the healthcare team, but may act as a starting point for discussion. If after reading it you have concerns or require further explanation, please discuss this with a member of the healthcare team.
Why do I need this procedure?
Your consultant has asked that you have this examination to look at the inside of your uterus (womb) and fallopian tubes; these are the tubes that carry eggs from the ovaries to the uterus.
This procedure is normally performed as part of a number of investigations into causes of infertility.
What are the benefits of this procedure?
This procedure is performed in the radiology department as an outpatient. No general anaesthetic is required.
How do I know if it is a suitable procedure for me?
Your doctor will have discussed this with you at your outpatient appointment.
Is there an alternative procedure?
Laparoscopy and Dye. This is an operation requiring a general anaesthetic.
Who will do the procedure?
The procedure will be performed either by a radiologist (a doctor who specializes in x-ray procedures) or a specialist nurse or radiographer.
How do I prepare for the procedure?
- To make sure that you are not pregnant when you have the hysterosalpingogram we ask you not to have unprotected sexual intercourse (sexual intercourse without the use of a barrier contraceptive such as a condom) from day one of your period until after the examination. It is important that you do not become pregnant at this time – please read the ‘Are there any risks?’ section.
- You may wish to take some pain relief about an hour before the procedure. Paracetamol (unless you have an allergy) or the type of pain relief you might normally take for period pain would be suitable.
- The hysterosalpingogram has to be carried out in the first ten days of your menstrual cycle. The first full day of bleeding is classed as day one of your period. The procedure cannot be carried out when you are menstruating/bleeding. You will be asked to telephone our booking team on, or as near to possible, the first day of your period to book your appointment. If you have been prescribed Provera (medication to induce a period) please let us know this when you contact us for your appointment.
Can I take my medication as normal?
Yes, there is no need to stop any of your medication.
What happens during the procedure?
In the x-ray department
On entering the x-ray room a radiographer (person who takes the x-ray pictures) and a nurse will greet you. They will check your personal details and discuss the procedure with you, you will be asked to undress completely apart from your bra and to put on a hospital gown. You will then be asked a number of questions to make sure it is safe to carry out the procedure and that you understand what will happen to you. If you have any questions about the test this would be a good time to ask.
During the procedure
You will then be asked to lie on the x-ray table in the same position as if you were having a smear test. A speculum will be passed into your vagina. This gently opens the vagina to help us to see your cervix (neck of the womb). A soft tube will then be passed through the cervix into your womb. This tube is used to pass the contrast (x-ray dye) through into your uterus and fallopian tubes. A series of x-ray pictures are taken whilst the contrast is passed through the tube. You may feel a cramp-like discomfort at this point.
Sometimes the contrast does not pass down the tube/s. If this happens we may give you a small injection, into a vein, of a drug called Buscopan. This will relax the smooth muscle in the tubes to increase the possibility of the contrast passing through them.
The Buscopan may also relax the smooth muscle elsewhere in your body including your eyes potentially giving you some temporary (approximately 20 minutes) blurring of your vision. It can also temporarily (approximately 20 minutes) increase your heart rate, but this is a normal side effect and is nothing to worry about.
Buscopan should not be given to people with glaucoma or heart disease. It is therefore important that we know if you have glaucoma or heart disease. Please inform us when you come to the department if you suffer from either of these conditions.
When the procedure is finished the tube and the speculum will be removed.
The contrast, which is colourless and has no smell, will be absorbed through your bowel and passed within your urine. Some of the contrast may come out of your vagina and you will be given a sanitary towel to wear following the procedure.
What happens after the procedure?
After the examination you may get some slight vaginal bleeding (spotting), this is not unusual. If you have pain you may take Paracetamol (unless you have an allergy) or the type of pain relief you would usually take for period pains.
You are advised not to wear a tampon for forty-eight hours after the procedure, you can use sanitary towels during this time.
Normal sexual activity can be resumed whenever you are ready to do so.
Are there any risks?
As with all procedures there are some potential risks involved when having a HSG
Minor:
There is less than a 1% chance of infection following the test. Triple swabs (three high vaginal swabs) will be taken either at your GP surgery or during your gynaecology outpatient visit before the test to rule out any infection.
There is a small risk of allergic reaction to the contrast. It is important to inform us if you are allergic to iodine.
There is a less than 1% risk of fainting during the procedure.
Major:
If you were pregnant and this procedure were performed then there is a high risk that you would miscarry or that the foetal (unborn baby) development could be affected by the x-rays.
How soon will I be back to normal?
You should expect to be in the department for an hour. It is best to have the whole day free on the day of the hysterosalpingogram as you may have cramping period-like pains afterwards.
If you have not had the injection of Buscopan to relax your tubes you can drive immediately.
If you have had the injection of Buscopan to relax the tubes you will need to wait an hour before driving because of the potential effect of this injection on the muscle in your eyes. It is advisable to bring someone with you to drive you home.
When do I get the results?
The person performing the procedure may be able to give you anidea of what the test has shown on the day of your HSG, but will need to study the images in more detail before giving a final report. The information is reported to the consultant who sent you for the test. Results will be given at your next follow up appointment.
What happens if I decide not to have the investigation?
You will be referred back to the doctor who advised the HSG to discuss further.
What if I have any special requirements?
If you have any special needs or requirements please contact the radiology appointments team on 0191 4452491 or the radiology nurses on the number below.
Where can I get more information?
Radiology nurses
Tel. No. 0191 445 3260 or 0191 482 0000 hospital switchboard and ask for bleep number 2687
Monday to Friday (9am to 5pm)
NHS 111