A hysterosalpingogram (HSG) is a commonly ordered test for women who are having difficulty conceiving a pregnancy because blocked fallopian tubes (hydrosalpinx) are a major cause of infertility world-wide. Approximately 25-35 percent of female factor infertility cases involve tubal disease. Understanding what an HSG is and what the risk factors are for tubal disease may help you understand if you need this procedure.
The HSG procedure uses fluoroscopy (similar to x-ray) to image the uterus and fallopian tubes as a radio-opaque dye is injected through the cervical canal. HSGs are used to evaluate the shape of a woman’s uterus and to see if her fallopian tubes are open. This test only takes a few minutes to perform and can give women and their physicians very useful information about their anatomy.
There are several risk factors for having tubal disease:
- Prior pelvic surgery – having had a surgery in the past can increase a woman’s risk of having scar tissue in her pelvis. This scar tissue can sometimes cause blockage of the fallopian tubes. Some surgeries that can cause pelvic scarring include removal of the appendix (especially if the appendix was ruptured), ovarian cyst removal, fibroid removal, C-sections, etc.
- Prior pelvic infections – sexually transmitted infections and other types of pelvic infections put women at risk for having scarring in or around the fallopian tubes. Pelvic inflammatory disease and chlamydia are two of the most common reasons for having fallopian tube blockage.
- Endometriosis – this is a disease that is notorious for causing inflammation in the pelvis. Over time, this inflammation can lead to scarring throughout the pelvis, including around the fallopian tubes.
If you have any of these risk factors and are having difficulty conceiving, you may want to ask your physician about having an HSG ordered. For more information about HSGs, visit our hysterosalpingogram page.