Hysterosalpingogram-HSG

A Hysterosalpingogram (HSG) is an X-Ray procedure that assesses the size and shape of the uterine cavity and the patency (opening) of the fallopian tubes by injecting non- or low iodine based (radiopaque) dye into the uterine cavity through the vagina and cervix. The HSG is done at the Reproductive Productive Partners Westminster office by an RPMG physician. You also have the option of having this procedure performed by another physician at another facility. The HSG is done under aseptic (clean) conditions and you will be awake and conversant during the HSG.

The HSG is usually performed after you have undergone a full menstrual cycle in order to minimize the interference or loss of an unknown pregnancy conceived in a prior cycle. Any irregularity in the timing of your menstrual flow or its character (i.e. amount, length, or type of flow) should be reported before you come in for your HSG, or to the physician before the HSG is begun. More importantly, if you have had pelvic pain, fever or vaginal discharge, please report this before the procedure.

Prior to the HSG appointment, your physician may prescribe prophylactic antibiotics to be taken beforehand to minimize the risk of infection secondary to the HSG. If so, you will be provided with a prescription prior to the HSG and you should follow your physician's directions.

To begin the HSG, you will initially be placed in a position similar to the one used for a pelvic exam. The physician will insert a speculum into the vagina in order to visualize the cervix. The cervix and vagina will be cleansed with either a Betadine or other cleansing solution. The cervix may be swabbed with a local anesthetic to minimize any discomfort. You may then be positioned so that you lie flat under the movable arm of the X-Ray machine.

The physician will place a narrow tube into the cervical opening and a clear radio-opaque dye will be injected into the uterine cavity and fallopian tubes. As the dye is being passed into the uterus and fallopian tubes, X-Ray pictures are being taken. You may be asked to change position from side to side in order to enhance visualization of your anatomy during the HSG. Once the HSG is completed, the instruments will be removed. You will be able to get dressed and leave the procedure room soon after the HSG. You may experience some mild cramping in the first hour after the HSG.

The physician will discuss the preliminary findings after the HSG. However, you should schedule a follow up consultation with your physician to discuss the next steps after all of your test results are ready. The results of the HSG will be used by your physician to determine ongoing treatment and services.

Some complications can occur as a result of an HSG. Although mild to moderate cramping is common during the 2 - 3 minutes that the dye is passed into your system some patients experience more severe cramping and pain which is much less common and usually resolves quickly.

Allergies to the iodine based dye solution may occur, but are rare. An allergic reaction may be limited to a rash or may be more serious which could require medication or, in very rare cases, hospitalization. IF YOU KNOW YOU ARE ALLERGIC TO IODINE OR RADIOGRAPHIC TYPE DYES OR HAVE A KNOWN ALLERGY TO SHELLFISH, PLEASE LET US KNOW BEFORE THE PROCEDURE BEGINS.

Light vaginal bleeding or spotting for 1 - 2 days after the HSG is common. However, heavy bleeding, fever, abnormal vaginal bleeding or abdominal pain lasting beyond the HSG could be signs of more serious complications and should be reported to the office quickly. These symptoms are uncommon but could be associated with pelvic infection or uterine perforation. These conditions could require hospitalization and/or surgery, and could result in uterine scarring which may interfere further with your ability to conceive. The use of antibiotics is intended to minimize the risk of infection but cannot entirely eliminate the risk.

Radiation exposure during the HSG is small and these doses are not known to injure ovaries, uterus, or eggs, including the egg(s) that may be developing for ovulation during this menstrual cycle. This HSG will be performed prior to ovulation to eliminate the potential that the liquid dye in the fallopian tubes could interfere with the efficient transport of egg(s) through the fallopian tube, which could minimize the chances of natural fertilization.

Alternatives

There are alternative procedures to an HSG which includes a combined operative procedure under general anesthesia called a hysteroscopy and laparoscopy, both of which are surgical procedures which look at the inside of the uterus and the outside of the fallopian tubes.

There is another procedure which uses saline fluid combined with sonogram (ultrasound) that can be an alternative in assessing the uterine cavity but it may not as fully assess the uterine architecture as the HSG and it is not capable of assessing the patency (opening) of fallopian tubes.

You also have the option of not assessing the uterine architecture or tubes for patency. However, the HSG procedure is recommended to gain important diagnostic information about the size and shape of your uterus and fallopian tubes and may increase your chances for pregnancy over the next few months.

Unlike HSGs done at other facilities, your HSG at Reproductive Partners will be done by a board certified reproductive endocrinologist. Their knowledge of your anatomy and comfort in working with women will help to make your procedure more comfortable and easier to tolerate. In addition, the physician performing the procedure will discuss the findings immediately after the procedure. There's no waiting until your OB/GYN gets the results.

Reproductive Partners Medical Group is pleased to announce a new low cash price for hysterosalpingograms (HSG) performed at our Westminster office - $395. This an all-inclusive price; both the procedure and the interpretation. Many other facilities promoting a low price include only the procedure and then add an additional charge for interpretation.