HSG of the fallopian tubes: indications, contraindications and procedure. Why, when planning a pregnancy, HSG of the fallopian tubes is prescribed How to behave after the HSG of the tubes

Hysterosalpingography (HSG) is a medical procedure in which a woman's uterus and fallopian tubes are visualized using x-rays of the pelvic organs. The main task of the HSG is to study the patency of the fallopian tubes for the possibility of having a child as a patient. Usually, HSG is done for women who cannot conceive a child with regular sexual activity, as well as for those representatives of the weaker sex who have had spontaneous abortion several times.

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The survey is carried out in several stages. The woman needs to lie down on the x-ray table. First, the doctor examines the patient on the gynecological chair using a medical mirror. During the procedure, the genitals are treated with an antiseptic and the labia is captured. Next, a special tube (cannula) is inserted into the uterine cavity, through which a contrast agent will enter the body. It is injected using a sterile syringe, and for ease of administration, a catheter for hysterosalpingography is used. Thanks to such a substance, the uterine cavity and fallopian tubes, which are hollow in structure, will be clearly visible on x-rays, and therefore are difficult to standard examinations.
As soon as the fluid is introduced into the uterus, the clamps on the labia are removed and pictures are taken from different angles. To do this, the patient is asked to change position on the table several times. At the end of the procedure, the hysterosalpingography catheter and cannula are removed. The substance used to make the images clearer is excreted from the body on its own.

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It is quickly absorbed into the circulatory system, broken down and excreted along with metabolic products.
Hysterosalpingography is a rather painful procedure, and therefore requires anesthesia. Since a woman needs to change body position during the HSG process, it is not advisable to do general anesthesia. Therefore, local anesthesia is usually used for the examination. For some patients, it is quite difficult to relax: the fear of pain and the unknown interferes. And in order for the contrast fluid to properly fill the internal genital organs, you need to remain calm and relaxed. Therefore, the patient may ask for a pill or an injection of a sedative (sedative) drug.
As soon as the painkiller begins to work, it will be possible to proceed with the introduction of the cannula and contrast agent. At this stage, pulling pains in the lower abdomen are possible, which remain quite tolerable. Such unpleasant sensations disappear on their own half an hour after the cannula is removed. Some patients, even with local anesthesia, can hardly tolerate the procedure and feel severe pain.

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In this case, the discomfort lasts longer and disappears only the next day.

Contraindications for the examination and preparation for it

This examination is carried out for women who have a preliminary diagnosis of infertility. This is the main indication. But there are a number of cases when this procedure is contraindicated. These include a woman's pregnancy, the presence of allergic reactions to a contrast fluid, and untreated infectious diseases of the reproductive system.
Therefore, before doing the HSG, the attending physician conducts a preliminary visual examination and takes smears for analysis. To exclude pregnancy, you will need to select a specific day of the menstrual cycle or conduct a standard test. If all the results are favorable for the procedure, the doctor will appoint the day of the procedure.
Preparing for the GHA is not difficult, but non-compliance with its basic rules threatens to give false results. In order for the decoding to be accurate, intimacy should be abandoned a day before the procedure. Also, a week before the examination, you should stop using cosmetics used for intimate hygiene, including soap.

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You can wash yourself only with warm water, and douching can be temporarily postponed.

Also, preparation includes the rejection of all types medical preparations used vaginally. The only exceptions are those drugs that were prescribed by the attending physician specifically for the HSG.

Compliance with a special diet and reduced physical activity in this case is not required.


On which day of the cycle is it better to prescribe hysterosalpingography? Of particular danger is the HSG for a pregnant woman. If a patient who had difficulty conceiving a baby undergoes this procedure, a spontaneous abortion will occur. Therefore, hysterosalpingography is always prescribed on the first days of the menstrual cycle. To completely exclude pregnancy, the patient is forbidden to have sexual intercourse from the beginning of menstruation until the HSG. Also, the beginning of the cycle is also favorable for the reason that the uterine epithelium is slightly thinner than before the onset of menstruation, and therefore does not close the entrance to the fallopian tubes and allows you to take clearer and more informative pictures. As a rule, for the HSG procedure, the doctor chooses the 7-10th day of the woman's menstrual cycle.

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Deciphering the results of hysterosalpingography

Performing pictures of the uterus and fallopian tubes, the specialist sees how the contrast is distributed in the internal organs of a woman. If during the procedure it is clear that the contrast has freely penetrated from the uterus into the fallopian tubes, and from there into the bloodstream, it can be concluded that the patient's fallopian tubes are completely patency.
Hysterosalpingography helps to identify a number of other pathologies that affect a woman's health and can become an obstacle to conceiving a child. These include:

  • uterine fibroids (benign tumor);
  • polyps;
  • adhesions;
  • hydrosalpinx, etc.

Despite the fact that the hysterosalpinography procedure has been used in medicine for quite some time, its results are not always accurate. According to scientific data, the accuracy of the examination is measured in two indicators: sensitivity and specificity. Thus, the sensitivity of hysterosalpingography, i.e., the ability of the procedure to detect existing pathologies, is only 65%. And specificity, i.e., information about the features of the pathology and its classification, is about 80%.

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Therefore, in last years hysteroscopy has become very popular. Its sensitivity is more than 80%, and therefore specialists in the field of gynecology increasingly prefer this examination.

What are the complications of the hysterosalpingography procedure?

This type of examination is considered safe, and therefore it is successfully used to diagnose the state of women's health in many countries. the only side effect hysterosalpingography may be an individual intolerance to the contrast agent used during the procedure. If a woman undergoing hysterosalpingography has already experienced a similar reaction of the body, the risk that she will have severe allergic reactions in subsequent times is very high. Also at risk of developing complications from the procedure are ladies suffering from respiratory diseases (bronchial asthma) and allergic to chemicals.
Another unpleasant consequence of the procedure can be perforation of the walls of the uterus and bleeding. Typically, such complications arise due to the low qualification of the specialist conducting hysterosalpingography.

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Also, non-observance of sterility during the examination threatens the development of various infectious diseases reproductive system.
To avoid unpleasant consequences and complications from the examination procedure, one should pay great attention to the choice of a clinic in which a woman will perform hysterosalpingography. Before you trust the doctor, you should study the reviews about his work, ask the specialist about his education, qualifications, work experience in this field. And in order to avoid allergic reactions, it is necessary to conduct allergy tests in advance and, in case of a positive result, abandon the procedure and find alternative methods of examination. So, today the standard procedure is being replaced by ultrasonic hysterosalpingography. The main difference between these methods is the use of ultrasonic waves rather than x-rays to study the condition of the uterus and fallopian tubes. The cavity of the internal genital organs is also filled with liquid, but in this case a special sterile saline solution is used, which does not cause allergic reactions.

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saline solutions

Unlike x-ray hysterosalpingography, ultrasound is less painful and does not harm the body, since there is no radiation.
And although the dose of radiation during the procedure is small and cannot affect physiological processes, it is still not worth being exposed to radiation once again. That is why the standard examination technique cannot be carried out more often.
The consequences of hysterosalpingography include small discharge (sometimes with blood, more often with thick mucus) from the vagina. They last for 3-4 days after the procedure. Uncomfortable sensations in the groin are possible, but these manifestations disappear on their own. In severe cases, you can take a No-shpa tablet.
The secretions should be scarce and it is recommended to use gynecological pads to absorb them. Tampons can not be used, as well as douching. Also, you should not visit baths and saunas, take a bath and conduct sexual life until the end of the allocation. If within a week after hysterosalpingography they do not stop or the woman's condition worsens, you should immediately seek medical help.

The fallopian tubes connect the ovary to the uterus, and the mature egg, moving from the ovary, is fertilized by the sperm in the tube. The tube then pushes the egg into the uterus. Fallopian tube obstruction is one of the reasons female infertility.

Obstruction may be due to:

  • operations on the pelvic organs (including removal of appendicitis);
  • transferred inflammation (most often - chlamydia).

Obstruction can occur not only in the tube itself, but also between the ovary and the tube as an adhesion (adhesion of the walls of the fallopian tubes and ovaries).

Fallopian tube adhesion

Is it necessary to remove the fallopian tubes in case of their obstruction?

  • Conservative treatment (no surgery) used in cases where obstruction is caused by inflammatory processes. At the same time, anti-inflammatory drugs, physiotherapy are prescribed, but in the case of the formation of adhesions, such treatment is ineffective.
  • Surgical treatment- surgical intervention. Usually, surgical treatment is carried out by laparoscopy - it practically does not give complications. But no one can give a 100% chance of curing infertility associated with impaired patency of the fallopian tubes. Removal of the fallopian tubes is an extreme measure, and is used in exceptional cases.

How to check the patency of the fallopian tubes?

Checking the patency of the fallopian tubes can be carried out in several ways:

  • diagnostic laparoscopy (checking the patency of the fallopian tubes is carried out, as a rule, during the operation to remove adhesions - laparoscopy is usually not prescribed just to check the tubes);
  • HSG (hysterosalpingography, MSG, metrosalpingography - other names);
  • hydrosonography (ultrasound);
  • fertiloscopy (a method similar to laparoscopy; often combined with it). The difference between fertiloscopy and laparoscopy is that the instruments are inserted not through the abdominal wall, but through the vagina.

How to check the patency of the fallopian tubes, which method to choose?

Taking into account the fact that both laparoscopy and fertiloscopy are traumatic methods, and ultrasound does not give a clear “picture of what is happening”, HSG is the optimal method in most cases.

HSG, or hysterosalpingography

Hysterosalpingography (HSG) - X-ray examination of the fallopian tubes for patency. Hysterosalpingography is an important stage in the examination of a woman diagnosed with infertility. The accuracy of the study is at least 80%.

Hysterosalpingography allows you to diagnose:

  • patency of the fallopian tubes;
  • the state of the uterine cavity and the presence of endometrial pathology - an endometrial polyp;
  • the presence of developmental deformities internal organs and uterus, such as saddle uterus, intrauterine septum, bicornuate uterus, etc.

How is tubal patency checked with HSG?

A contrast agent is injected into the cervix - a blue solution. It fills the uterine cavity and enters the tubes, from which it flows into the abdominal cavity. In this case, an x-ray is taken, which shows the state of the uterine cavity and fallopian tubes.

In most cases, the procedure helps not only to assess the patency of the fallopian tubes, but also makes it possible to see the presence of tube deformation:

  • extension;
  • tortuosity;
  • braces, etc.

Hysterosalpingography can be performed only in the absence of inflammation. Before the start of the examination, they are tested for HIV, hepatitis B and C, syphilis, as well as a general smear for the flora. HSG does not require general anesthesia.

As a rule, in women who are trying to become pregnant, hysterosalpingography is performed on the 5th-9th day of the menstrual cycle, if its duration is 28 days. If a woman is protected from pregnancy, the examination is possible on any day of the cycle, except for menstruation.

Disadvantages of hysterosalpingography

  • The procedure is rather unpleasant.
  • The pelvic organs are irradiated.
  • After HSG during one menstrual cycle it is necessary to be protected.

Hysterosalpingography

Ultrasound of the patency of the fallopian tubes

Testing for patency of the fallopian tubes Ultrasound (hydrosonography) is an alternative to hysterosalpingography. Ultrasound has several advantages over HSG:

  • less unpleasant procedure;
  • unlike HSG, no radiation is used, which can have a negative impact on a woman's reproductive health;
  • while careful protection is required after HSG, tubal ultrasonography is safe.

The main drawback of the procedure is the lower accuracy of the results compared to the HSG.

When is the patency of the ultrasound tubes checked?

An ultrasound tube test is usually performed on the eve of ovulation: at this time, the likelihood of spasm is reduced and the cervical canal is dilated. Unlike hysterosalpingography, in this case it is not very important on which day of the cycle the tubes are checked for patency using an ultrasound scanner. Before checking the patency of the fallopian tubes, it is necessary to take tests to exclude the presence of inflammatory diseases.

How is the patency of the fallopian tubes checked by ultrasound?

Determining by ultrasound the patency of the fallopian tubes is almost painless. A special catheter is inserted through the cervix into the uterine cavity, warm saline is slowly poured into it under ultrasound control. If it flows into the fallopian tubes, then the tubes are passable. If not, their obstruction is likely.

Disadvantages of checking the patency of the fallopian tubes by ultrasound:

  • relatively large amounts of fluid, as well as spasms of the uterus and fallopian tubes, discomfort can be caused;
  • if the ultrasound showed that saline does not pass, this may not always mean obstruction of the tubes. The reason for this may be a strong spasm.

Laparoscopy. How to check the patency of the fallopian tubes with its help?

Laparoscopy is a surgical method for assessing the patency of the fallopian tubes. Through punctures in the abdominal wall with the help of optical instruments, an examination of the internal organs is carried out. If you are scheduled for laparoscopy, the forum can help you choose a clinic or even a surgeon.

Laparoscopy in gynecology is a method for the treatment and diagnosis of various pathologies of the pelvic organs. Laparoscopy is one of the modern methods surgery with minimal intervention and skin damage. Laparoscopies are performed for both diagnostic and therapeutic purposes.

Laparoscopy can be performed to clarify various diagnoses. If you feel pain after laparoscopy, contact the clinic where you had the operation.

Diagnostic laparoscopy is an operative research technology in which the doctor examines the abdominal organs without making large incisions on the abdominal wall. Most often, two small incisions are made. In order to increase the field of view, a a small amount of gas.

A device called a laparoscope is inserted into one incision - a thin tube at one end with a lens, and at the other with an eyepiece (the second end can also be connected to a video camera unit that transmits an image to the screen). A manipulator is inserted into another incision, with the help of which the doctor displaces the abdominal organs, carefully examines them and makes a diagnosis.

Diagnostic laparoscopy is performed to assess the condition of the outer surface of the fallopian tubes and pelvic organs, as well as to identify their pathologies.

The most common operations:

  • laparoscopy of the ovaries;
  • laparoscopy of the fallopian tubes;
  • laparoscopy of the abdominal organs.

After laparoscopy:

  • The patient stays at the hospital, as a rule, for no more than a day: doctors monitor her condition, perform an ultrasound scan. After 2-3 days you can return to work.
  • It is not recommended to drink alcohol and heavy food in the next 2-3 weeks after the operation. - Sex should be postponed for 2-3 weeks to avoid infection.
  • Physical exercise should be raised evenly. It is better to start with walking and gradually increase their duration. Heavy after the operation should not be lifted.

Laparoscopy of the ovaries

This procedure is performed not only to remove cysts. At the same time, this is the most effective method of treating ovarian cysts of a different nature. It can also be an effective treatment for endometriosis, a disease in which cells from the inner layer of the uterine wall grow outside of this layer. In this case, an endometrioid cyst may form.

Laparoscopy of the ovaries allows you to remove the cyst and adhesions, return the woman the opportunity to have children. Literally a couple of days after the laparoscopy of the ovarian cyst was performed, he returns to his normal boundaries and fully restores his functions.

Pain after laparoscopy is very rare, the stitches usually heal quickly without causing discomfort - painkillers are taken in extreme cases, as directed by a doctor.

Laparoscopy of an ovarian cyst is not an easy operation. Select good doctor, because often the appearance of cysts in the future, as well as the possibility of pregnancy, depends on the accuracy of the operation.

Laparoscopy of the uterus

Laparoscopy of the uterus is an effective way to treat fibroids. The operation is also prescribed for the treatment of various malformations of the uterus.

Laparoscopy of uterine fibroids

The determining factors in choosing a method for treating uterine fibroids are the intention to have children in the future, the size of the uterus, the size of the myoma nodes, and their location. Laparoscopy is a good option for removing small fibroids.

Laparoscopy of uterine fibroids is not performed in such cases:

  • the size of the uterus is larger than the fetus at the 11-12th week of pregnancy;
  • multiple myomatous nodes developed;
  • the size of the nodes is large;
  • myoma nodes are located low.

In these cases, it is better to use other methods of removal, such as laparotomy.

Treatment of fallopian tubes with laparoscopy

Tubal laparoscopy is a method in which anesthesia is used, and the occurrence of spasm is excluded. Therefore, checking the tubes using laparoscopy gives a very accurate results. Laparoscopy of the fallopian tubes allows you to remove adhesions. The operation of laparoscopy is prescribed if treatment of the fallopian tubes and their pathologies is necessary.

Laparoscopy of the tubes may be prescribed in the following cases:

  • formation of adhesions of the fallopian tubes;
  • ectopic pregnancy;
  • obstruction of the fallopian tubes;
  • diagnosis of female infertility;
  • endometriosis;

Period after laparoscopy

If menstruation is painful, then the first menstruation after laparoscopy usually passes with more blood loss than usual and longer duration. This is because internal organs take longer to heal than incisions in the abdominal wall. In this regard, the first menstruation is usually more painful. But still, with a strong menstrual pain should consult a doctor.

Pregnancy after laparoscopy

After laparoscopy is done, you can become pregnant within a few months, but immediately after the operation for 2-3 weeks, you must completely abandon sexual intercourse. After that, you can plan conception. Pregnancy after laparoscopy is quite possible in the near future.

Women who have become pregnant after laparoscopy within a few months are observed by a gynecologist. Often pregnancy is accompanied by drug treatment, a woman takes drugs to support the normal hormonal background of pregnancy. If pregnancy does not occur after laparoscopy, this operation can be repeated several times.

Laparoscopy - reviews

If you are scheduled for laparoscopy, the forum is not the best source of information. It can come in handy in one case: if you want to choose a clinic or a doctor: patients who have had laparoscopy leave reviews very willingly.

Is it worth restoring the patency of the pipes?

You can get pregnant within about a year after the restoration of the patency of the tubes - the likelihood that they will soon become impassable again is very high. In addition, the tube should not just be passable: it should move the fertilized egg to the uterus. If she does not do this, an ectopic pregnancy is formed.

Any operation to restore tubal patency increases the risk of ectopic pregnancy. Thus, the restoration of patency is far from a guarantee that you will be able to get pregnant. In addition, any operation can start the process of adhesion formation.

If you are young and there are no more factors that prevent you from getting pregnant, it makes sense to operate the tubes. If you are over 35 and have been trying to have a baby for a long time, consider artificial insemination. With each ovulation, the "quality" of the eggs deteriorates, and you should not waste months on the restoration of the tubes - time is against you. Based on everything that we have described above, consult with your doctor to find out if you should even deal with the restoration of tubal patency.

Hysterosalpingography is a method of hardware examination in gynecology. Using this technique, doctors determine the condition of the fallopian tubes, their morphological and anatomical features. The main purpose of the study is to determine the patency of the fallopian tubes.

Hysterosalpingography - what is it?

Having seen a record in the direction issued by the doctor: HSG of the fallopian tubes, most patients have no idea what this procedure is. This technique involves the study of the tubes of the uterus and its appendages. The main parameter that doctors examine during this procedure is the patency of the uterine tubes. This factor is of great importance for the successful and bearing of the child. The method is often used to diagnose infertility in women with a long-term absence of pregnancy with its active planning.

What does hysterosalpingography show?

Hysterosalpingography of the fallopian tubes allows doctors to assess the state of one of the most important parts of the reproductive system from the inside. Directly in the fallopian tubes, a meeting of male and female germ cells occurs, therefore, complete or partial obstruction of patency becomes an obstacle to normal conception.

In addition to pathologies of the fallopian tubes, gynecologists use hysterosalpingography to establish a number of other gynecological diseases:

  • pathology of the uterus - polyps, deformities, endometriosis,;
  • adhesions of the fallopian tubes;
  • cysts of the reproductive system;
  • tumor-like processes in the uterus and its appendages (including malignant ones).

Hysteroscopy and hysterosalpingography - what's the difference?

The technique of hysterosalpingography is based on the study of the fallopian tubes and the uterine cavity using an X-ray machine. The doctor introduces a special contrast agent into the patient's reproductive system, which helps to better structure the tissues. During the procedure, specialists take several pictures, which are then used to describe and diagnose possible pathologies of the reproductive system.

Hysteroscopy is a simple examination of the uterine cavity using a special optical device. This method cannot be used to obtain information about the condition of the fallopian tubes, it is impossible to visualize them using a hysteroscope. The main purpose of the method is to assess the state of the uterine cavity, endometrium.

The method is used to detect the following pathologies of the uterus:

  • polyps of the uterine cavity;
  • cystic formations;
  • inflammation of the endometrium.

Hysterosalpingography - indications

A fallopian tube test (HSG) can only be carried out with the direction of a doctor. The specialist decides on the need for research, analyzing the clinical picture, the patient's complaints. Often, the procedure is included in the list of examinations when diagnosing the cause of a prolonged absence of pregnancy.

In addition, hysterosalpingography is prescribed by a gynecologist if there are suspicions of a number of pathologies, possible anomalies in the development of the reproductive organ:

  • violation of the anatomy of the uterus and appendages (, tortuous fallopian tubes);
  • fibroids of the reproductive system;
  • adhesions of the fallopian tubes;
  • cystic formations;
  • polyps.

Hysterosalpingography - contraindications

Due to the presence of a number of contraindications, doctors are not always able to perform HSG: the patency of the fallopian tubes in this case remains in question. Before prescribing an examination procedure, the doctor carefully examines the patient's condition, her medical history, takes into account the presence of other pathologies and inflammatory processes in the woman's body.

Hysterosalpingography is not performed in the following cases:

  • the period of pregnancy (especially short terms);
  • allergic reactions to a contrast agent (allergic tests for iodine-containing substances are preliminarily carried out);
  • uterine bleeding in history;
  • inflammatory processes in the body, in the area of ​​the reproductive system and small pelvis;
  • period of exacerbation of chronic diseases;
  • hyperthyroidism;
  • thrombophlebitis;
  • tumors and cysts in the uterus and appendages;
  • viral and bacterial infections in the body.

HSG of the fallopian tubes - preparation for the procedure

Preparation for HSG of the fallopian tubes should begin 7 days before the study. From this moment on, a woman needs to cancel all douching, the use of intimate hygiene products, vaginal creams, and suppositories. Three days before the scheduled procedure, it is necessary to exclude sexual intercourse. The procedure is performed on an empty stomach. Before the HSG, a woman must undergo a series of examinations. The list of them in different clinics may vary.

In most cases, before a hysterosalpingography is performed, preparation for the procedure involves the delivery of the following tests:

  • blood analysis;
  • testing for syphilis, HIV, hepatitis;
  • Analysis of urine;
  • on the flora of the vagina;
  • cytological scraping of the cervix.

On what day do the HSG of the fallopian tubes?

For women who are to undergo hysterosalpingography, on which day of the cycle to do it, the gynecologist tells. Directly he appoints the time and day of the procedure. The timing of its implementation is determined by the type of pathology. However, in most cases, doctors believe that the best time for research is the period from the beginning of the cycle (after menstruation) to ovulation. So, for women with a menstrual cycle of 28 days, the optimal time for examination is 6–12 days after menstruation. If there is evidence, doctors conduct an urgent examination on any day, except for the period of menstruation.

Hysterosalpingography - what to bring?

Hysterosalpingography, HSG, does not require a woman to have special devices or things. All you need to take with you is a diaper or a large towel. Some doctors recommend grabbing sanitary pads. They are necessary, because after the procedure, abundant vaginal discharge is not uncommon. Everything else will be given to the patient at the clinic where the examination procedure will be carried out.

Hysterosalpingography - does it hurt?

The main question of women who are to be examined for the first time concerns whether it hurts to do hysterosalpingography. In most cases, the manipulation is performed without the use of anesthesia. In this regard, patients may note some discomfort:

  • soreness in the lower abdomen;
  • light sips in the groin, as during menstruation;
  • discomfort in the pelvic area.

To exclude this, some medical institutions perform the procedure under local anesthesia. In some cases, the patient may be asked to take an antispasmodic drug. It helps to reduce tension and contractility of muscles, reduce pain. Women who are very worried about the course of the procedure are given a sedative the day before.


How is hysterosalpingography performed?

When receiving a referral for an examination, a woman wants to get acquainted with the algorithm of the procedure. How the HSG of the fallopian tubes is done, how long the manipulation lasts, whether the pain is strong - the answers to these questions will have to be given to the doctor who sends the woman for examination.

In a conversation with a patient, doctors pay special attention to important preparation rules:

  1. On the eve of the study, it is recommended to do an enema to completely cleanse the intestines.
  2. On the day of the study, it is forbidden to eat.
  3. 1.5 hours before the examination, you can drink a glass of water without gas.
  4. If the hysterosalpingography is performed using ultrasound, the woman, on the contrary, will have to drink a lot of fluid to fill the bladder.

X-ray hysterosalpingography

HSG X-ray of the fallopian tubes is one of the first methods for their examination. Directly with its help, gynecologists for a long time established the condition of the fallopian tubes, the uterine cavity, and diagnosed tubal infertility. The method consists in introducing a special solution into the uterine cavity, which fills the main organ of the reproductive system and gradually penetrates the tubes. Doctors receive the most detailed pictures, evaluate the body from the inside.

The algorithm boils down to the following:

  1. The patient is located in the gynecological chair.
  2. The doctor installs mirrors, cleans the vaginal cavity with sterile swabs.
  3. A special cannula is inserted into the cervical canal, through which a contrast agent is supplied.
  4. The mirrors are removed and the uterine cavity is filled with contrast through a special catheter for hysterosalpingography.
  5. After that, the woman is offered to lie down on a special table, over which the X-ray machine is located.
  6. The doctor takes pictures at a certain interval, which then evaluates the process of moving the substance through the fallopian tubes.

Ultrasound hysterosalpingography

Ultrasound, or as it is also called, ECHO HSG of the fallopian tubes involves the study of the reproductive system using ultrasound. The principle of the study itself is similar to that discussed above, however, saline is used instead of a contrast solution. On the monitor screen of the ultrasound machine, the doctor manages to visualize the fallopian tubes and the injected solution. If it reaches them and penetrates into the abdominal cavity, the fallopian tubes are passable, there are no pathologies. Otherwise, the doctor in the conclusion indicates the degree of damage, the nature of the changes.

Hysterosalpingography - normal

After the HSG procedure of the fallopian tubes is carried out, the doctor carefully examines the information received. In conclusion, not only the degree of patency is indicated, but also the main parameters of the fallopian tubes. The documents issued to the woman are accompanied by several photographs, which clearly show possible violations. If necessary, the entire procedure is recorded on disk.

In the conclusion of a normal hysterosalpingography, the following information is indicated:

  • the uterine cavity has the shape of an isosceles triangle with a base of 4 cm;
  • the fallopian tubes are contrasted on both sides;
  • ampullary fallopian tubes within normal limits;
  • the contrast agent enters the abdominal cavity.

HSG of the fallopian tubes - consequences after the procedure

With the correct, competent conduct of the HSG of the fallopian tubes, the consequences of the procedure for the woman's body are practically excluded. Minor discomfort, reminiscent of pain on the eve of menstruation, together with mild pink discharge, is a variant of the norm. After 2-3 days from the moment of the examination, they completely disappear.

Physicians are of great concern possible complications GHA. Chief among them are allergic reactions to the contrast agent. In addition, the use of a large volume of contrast can lead to the fact that it begins to penetrate into the capillaries, lymphatic vessels, and also into the venous network of the reproductive organ. Excessive administration of fluid can provoke a rupture of the fallopian tube, which requires emergency medical attention.

Pregnancy after HSG of the fallopian tubes

Doctors forbid planning pregnancy after hysterosalpingography in the cycle following the procedure. This is due to the possible negative effect of contrast and X-rays on the reproductive system of a woman. In the case of HSG using ultrasound, these restrictions do not exist.

In general, women after hysterosalpingography, in the absence of impaired patency of the fallopian tubes, can freely plan conception. When, during the course of the study, adhesions and other formations that violate, doctors prescribe complex treatment.

Hysterosalpingography (another name for metrosalpingography) is an examination method that allows you to see the internal outlines and. There are two types of this procedure: using x-rays or using ultrasound. Classical hysterosalpingography is a radiological examination, that is, a series of x-rays is taken for its implementation.

Which is better: ultrasound or X-ray?

As mentioned above, there are two types of hysterosalpingography: using ultrasound (another name for sonohysterography) and using x-rays. When comparing these examination methods, it is impossible to single out the best, since each is designed for a specific purpose.

Sonohysterography (HSG with ultrasound) is mainly used to examine the uterine cavity. With the help of this examination, anomalies in the development of the uterus, deformation of the uterine cavity and other possible reasons infertility. But an ultrasound examination cannot reliably determine whether the fallopian tubes are passable.

Hysterosalpingography with X-ray is the main method for assessing the patency of the fallopian tubes. Most experts believe that the X-ray method is indispensable if you need to check the fallopian tubes.

When is hysterosalpingography prescribed?

Hysterosalpingography is widely used in the diagnosis of infertility, as it allows you to determine the shape of the uterine cavity and find out if the fallopian tubes are passable. This type of examination can be assigned:

  • If you suspect an obstruction of the fallopian tubes (for example, as a result of adhesions with, and other diseases)
  • If you suspect an anomaly in the structure of the uterus (bicornuate uterus, underdeveloped uterus, septum in the uterus, etc.)
  • If you suspect or
  • Before ovulation stimulation (for example, with)
  • If you suspect

In what cases is hysterosalpingography not possible?

Contraindications to this procedure are:

  • Pregnancy or suspected pregnancy
  • Inflammatory diseases of the vagina or uterus
  • Severe uterine bleeding

How should I prepare for a hysterosalpingography?

Some time before the procedure, you should visit a gynecologist and pass. This examination will make sure that there is no inflammation in the vagina and cervix that can enter the uterus during a hysterosalpingogram. If inflammation is detected, then hysterosalpingography cannot be performed until a complete cure. Also, before the examination, you may be prescribed tests for HIV infection, viral hepatitis, etc.

Ask the doctor who will perform the procedure if there is a need for prophylactic antibiotics before hysterosalpingography.

On which day of the menstrual cycle can a hysterosalpingography be done?

If you are protected during sex and pregnancy is excluded, then hysterosalpingography can be performed on any day of the cycle, except for the days of menstruation.

If you are not using protection, then it is better to carry out the procedure in the first half of the cycle (immediately after the end of menstruation), since these days the probability of pregnancy is the lowest.

Is hysterosalpingography painful?

This procedure is painless, but may feel somewhat uncomfortable or unpleasant. Hysterosalpingography does not require anesthesia. In order to reduce discomfort during the procedure, the gynecologist may apply a local anesthetic to the cervix.

How is hysterosalpingography performed?

So, you will be asked to sit in a gynecological chair with your legs spread, as during a simple examination. The gynecologist will insert a speculum into the vagina to help them see the cervix. After treating the cervix with an antiseptic (so as not to bring the infection into the uterus) and a local anesthetic (to reduce discomfort), the gynecologist will insert a special catheter into the canal (through which a contrast agent will be injected into the uterus) and remove the mirror from the vagina. You will be asked to position yourself under the x-ray machine. After that, a contrast agent will be injected through the catheter into the uterus. During the administration of the substance, a series of x-rays are taken. At the end of the procedure, the catheter will be removed.

What substance is injected into the uterus during hysterosalpingography?

Since the uterus and fallopian tubes are not visible on a simple x-ray, special substances that do not transmit x-rays are used to detect them. These substances are called contrast agents.

For hysterosalpingography, contrast agents Verographin, Urographin, Triombrast, Ultravist and others are used. All of these substances contain iodine. These drugs are sterile, so if the procedure is carried out correctly, the risk of infection of the uterus or other internal organs is minimal.

What will be the sensations after hysterosalpingography?

Discharge: After a hysterosalpingogram, you may have a thick, dark brown discharge that resembles blood. This leaves the remains of the contrast agent, and possibly pieces of the endometrium (the inner lining of the uterus). Use in case of discharge.

Pain: Minor pain in the lower abdomen after hysterosalpingography is also possible. They are associated with contractions of the uterus, which can be "irritated" by the procedure. To eliminate pain, you can take a pill No-shpy.

What complications are possible with hysterosalpingography?

Complications of hysterosalpingography are very rare if the procedure is carried out correctly. There is some risk of the following complications:

  • An infection that enters the uterus from the vagina or cervix can lead to the development of inflammation of the uterine mucosa (acute or).
  • Allergy to the contrast agent. If you have an allergy to iodine or other substances, be sure to inform your gynecologist.

The risk of damage to the uterus or fallopian tubes is very small, especially if the hysterosalpingography is performed by an experienced gynecologist.

Be sure to contact your doctor if:

  • Vaginal discharge does not stop within 2-3 days after the procedure, or has acquired an unpleasant odor
  • Body temperature after the procedure increased to 37.5 C or higher
  • You have severe pain in your lower abdomen
  • You have severe weakness, nausea, vomiting after hysterosalpingography

What are the normal results of hysterosalpingography?

Normally, the pictures show a triangular-shaped uterus, from which two fallopian tubes extend, having the form of winding "threads". At the ends of these "strings" there may be spots of an indefinite shape, which indicate that the contrast agent has passed through the fallopian tube and "poured out" into the abdominal cavity. This is a sign that the fallopian tubes are patent.

If only one thread leaves the triangle, then only one fallopian tube is passable, if there are no threads at all, then both tubes are impassable.

When can pregnancy be planned after hysterosalpingography?

Since a contrast agent is injected into the uterus during x-ray hysterosalpingography, it is not recommended to plan a pregnancy in the same cycle. You will be able to start conceiving a child in the next menstrual cycle (after the end of the next period).


HSG X-ray (X-ray hysterosalpingography, WG-HSG) is a diagnostic technique designed to assess the condition of the female genital organs. The essence of the study is that a catheter is inserted into the uterine cavity, through which a contrast agent is supplied. It is this that will be seen during the performance of a series of X-ray images. After it is evenly distributed throughout the uterus and appendages, the doctor “sees through” the organs using an X-ray machine. The resulting images will clearly show the fallopian tubes and uterus.

Using this procedure, it is possible to detect such pathologies of the genital organs as obstruction of the fallopian tubes, endometriosis growths in the uterus, structural abnormalities, etc. This method is often recommended for women who suffer, since these factors most often lead to the fact that patients cannot become pregnant .

It is possible to perform the procedure both in an outpatient clinic and in hospitals of gynecological departments. The main condition for its implementation is the presence of an X-ray apparatus and a specialist who knows how to work on it.


During hysterosalpingography, the woman is in the gynecological chair. After the doctor injects a contrast agent into the uterine cavity, it is necessary to withstand some time. This will allow the liquid to be evenly distributed throughout the internal genital organs. After that, one or more pictures are taken, which allow you to evaluate the result.

If a woman does not have any pathologies, then the uterus looks like a regular triangle, and the tubes are arched. In the presence of diseases, the picture changes: it is possible to detect neoplasms (myomas), partitions, adhesions, etc. If a woman has obstruction of the fallopian tubes, then the contrast agent will be distributed unevenly, and obstacles in its path will be clearly visualized.

The procedure does not require the introduction of anesthesia, as it does not cause pain. However, if a woman has a high threshold of pain sensitivity, then local anesthesia is indicated for her.

HSG and ultrasound - is it the same thing?


HSG and ultrasound are two different procedures. Ultrasound examination involves an overview of the internal organs of the patient and the detection of a possible pathology by changing their structure and density. The picture is displayed on the monitor. To perform an ultrasound, there is no need to perform any additional procedures. It is enough just to lubricate the surface to be viewed with a special gel.

HSG involves the introduction of a contrast fluid into the uterus. After its distribution, the doctor performs a series of images using an X-ray machine (but it is possible to examine the internal organs on an ultrasound machine). The introduction of a contrast agent allows you to make the study more informative. In addition, the doctor can diagnose blockage of the fallopian tubes, which cannot be done during a conventional ultrasound examination.

Since two devices can be used for HSG: X-ray and ultrasound, there is a difference in the course of diagnostics. If the pictures are taken on x-ray equipment, then the procedure is called "X-ray hysterosalpingography". When an ultrasound machine is used to perform the study, the technique is called echohysterosalpingography. Due to the similarity in name, many people believe that these procedures are identical, in fact, their essence and diagnostic significance are different.

Which is better: X-ray or HSG?


A standard x-ray examination will not reveal obstruction of the fallopian tubes or other pathologies of the pelvic organs, so it is never used for this purpose. HSG, on the contrary, is the method of choice for suspected obstruction of the fallopian tubes, endometrial polyps, uterine myoma, and other pathologies of the female reproductive system. Therefore, HSG is definitely better than X-ray.

However, it should be understood that HSG is performed either with the help of an X-ray machine or with the help of an ultrasound diagnostic machine. The internal genital organs of a woman become visible on them after the introduction of a special contrast agent into the uterus and fallopian tubes. Many specialists use the term "X-ray" to refer to the procedure for examining the fallopian tubes on an X-ray machine, and the term "HSG" to conduct a study on an ultrasound machine. If we consider the issue from this point of view, then the GHA will be better than "X-ray".

The fact is that Echo-HSG has the following advantages over RGHA:

    A woman will not have to use contraceptive methods that protect her from pregnancy if she has been prescribed an ultrasound HSG.

    There are no contraindications for conceiving a child in the month when Echo-HSG was performed.

    During the procedure and after it, there is no risk of an allergic reaction to the contrast agent, which contains iodine in its composition.

    The patient's body will not be irradiated by the x-ray machine. Moreover, this negatively affects the number of eggs that are present in the ovarian follicles (ovarian reserve).


HSG of the fallopian tubes is carried out by gynecologists and gynecologists-oncologists.

The indications for the procedure are as follows:

    tubal infertility;

    Adhesions of the pelvic organs;

    Anomalies in the development of the reproductive organs;

    Sexual infantilism;

Hysterosalpingography is the method that will confirm that a woman has a pathology of the fallopian tubes or uterus, but does not always make it possible to assess the severity of the disease and its nature. If we turn to statistics, then in 98% of cases it is possible to identify an existing violation, but it is possible to make a correct diagnosis only in 35% of cases.



X-ray hysterosalpingography may not always be performed.

There are certain contraindications to the procedure, including:

    Intolerance to iodine preparations. This contraindication is due to the fact that the composition of the contrast agent, which is injected into the uterine cavity, contains iodine.

    Inflammation of the ovaries, uterus, appendages.

    Violation of blood clotting.

    Heart disease.

    Severe disorders in the liver.

    Pathology of the thyroid gland.

    Pregnancy. Carrying out a pregnancy test is a prerequisite before undergoing the procedure.

    Menstrual bleeding.

    Lactation.

    Increased ESR and leukocytosis.

Preparation for the procedure is simple, but following the recommendations given by the doctor is a prerequisite. Otherwise, you can harm your own body.

So, a woman must follow the following rules in order to qualitatively prepare for hysterosalpingography:

    1-2 days before the proposed study, you need to give up intimacy.

    7 days before the procedure, do not douche or use intimate hygiene products inserted into the vagina.

    7 days before the study, it is forbidden to use vaginal tablets, suppositories and ointments for treatment.

    2-3 days before the study, you need to change your diet, refusing to eat foods that provoke excessive gas formation. This applies to cabbage, legumes, bread, dairy drinks, soda.

    7 days before the procedure, you should stop using tampons.

    After the end of the next menstruation, partners must use a condom to avoid conception.

It is equally important to undergo a qualitative examination before the GHS. It necessarily includes the delivery of the following tests:

    Blood test for syphilis, HIV,.

    A smear from the vagina and from the cervix.

Before you go for the procedure, you need to remove all hair from the external genital organs, wash them thoroughly. Bladder and the bowels must be empty. If it was not possible to go to the toilet, then an enema should be done. The procedure must be carried out on an empty stomach.

As for self-administration of painkillers, without consulting a doctor medicines use is prohibited. As prescribed by the doctor, it will be possible to drink an antispasmodic, for example, No-shpu, 30 minutes before the HSG.

When is the HSG performed?

Most often, hysterosalpingography is performed within 2 weeks after the next menstruation. This is due to the fact that during this period the uterine mucosa has a small thickness, which means it does not block the entrance to the fallopian tubes.

Although, depending on the purpose of the study, it may be scheduled at other times. To assess the patency of the fallopian tubes, it is carried out in the second half of the menstrual cycle. If there is a suspicion of internal endometriosis, then it is recommended to perform HGS on the 7th-8th day of the cycle. Fibroids in the submucosal layer of the uterus can be detected at any time, but only on condition that the woman does not have menstruation.

How is the HSG performed?

If the doctor's office is equipped with a special X-ray chair, then the woman is seated on it. If there is no such chair, then the patient will be located on a regular gynecological chair, and an x-ray machine will be brought to her.

After treating the external genital organs with an antiseptic composition, the doctor inserts mirrors into the vagina and wipes the vaginal walls first with dry cotton wool, and then moistened with an alcohol solution. The next step is to insert the tube into the cervical canal. The tube is attached with bullet tongs. When this manipulation is done, the mirrors are removed. A contrast agent is supplied through the tube with a syringe, which must first be warmed up to approximately the woman's body temperature (up to 37 ° C).

When the contrast agent is evenly distributed throughout the uterine cavity and fallopian tubes, the doctor begins to take pictures. As a rule, the doctor takes 4 to 6 pictures during the procedure. To begin with, the state of the uterus (its relief) is fixed. Then another 4 ml of a contrast agent is injected into the cavity, which makes it possible to more clearly visualize the appendages. If this volume of liquid is not enough, then enter as much as necessary.

After all the pictures are taken, the patient is transferred to the couch and left in a horizontal position for another hour. The fluid that was injected during the procedure is absorbed into the bloodstream and excreted from the body by the liver and kidneys.

What contrast agent is used for HSG?


For the procedure, the introduction of a contrast fluid is shown, which has the ability to delay x-rays. These are drugs such as:

    CardioTrust. This is a contrast agent that can contain 50% and 30% iodine.

    Urotrast, Triombrast and Verographin. These are three analogues belonging to the group of radiopaque substances, which may contain 60% and 76% iodine.

Interestingly, for the first time, hysterosalpingography was tried with Lugol's solution in 1909. But due to the occurrence of irritation of the peritoneal cavity and uterus, this attempt was unsuccessful. A year later, the Lugol solution was replaced with bismuth paste, and then with argyrol and collargol. However, it was not possible to achieve the desired effect with the use of these substances. In addition, all of them entailed inflammatory processes of the peritoneum.

Only in 1925, the scientist Heuser first used Lipiodol (a preparation containing iodine) for hysterosalpingography. This substance made it possible to visualize the condition of the uterus and fallopian tubes well, and also did not harm the health of the woman. Since then, the procedure has been introduced into medical practice.

Consequences and complications of HSG


A woman should use sanitary pads for 2-3 days after the procedure. This need is due to the fact that the remains of the contrast agent can flow from the vagina. If a small amount of blood is found in the discharge, then you should not worry about this, since such a phenomenon is a variant of the norm.

Mild pain, reminiscent of those that occur during the next menstrual cycle, should not frighten a woman. After the HSG, such discomfort does not indicate any complications.

Also, the patient should be prepared for the fact that during or several hours after the HSG, a metallic taste in the mouth, dizziness, and increased heart rate may occur. This is a normal reaction of the body to the introduction of a contrast agent.

A woman should not visit a sauna or a bath, as well as take a hot bath for 3-4 days after undergoing the HSG.

To show concern and immediately consult a doctor should be with an increase in body temperature, heavy bleeding or severe pain in the lower abdomen.

Extensive blood loss, infection, perforation of the uterus and fallopian tubes during the HSG procedure in modern gynecological practice are extremely rare, as an exception.

A woman should refrain from pregnancy for the next 3 months. For protection, you should use a condom.

As a rule, the procedure is well tolerated, but only on condition that the preparation for it is carried out qualitatively: inflammatory processes were detected in time, there are no other contraindications to HSG.




The doctor should interpret the results based on the images obtained.

signs various diseases on the X-ray picture are as follows:

    Noticeable asymmetry of the uterus - the diagnosis of "unicornuate uterus".

    An elongated cervix and a pronounced decrease in the volume of its cavity is the diagnosis of "infantile uterus".

    Short, long, or asymmetric fallopian tubes - the diagnosis of congenital obstruction of the fallopian tubes.

    The presence of a flask-shaped expansion in the tubes is a possible diagnosis of "fallopian tube adhesions", or "sactosalpinx", or a combination of these two diagnoses.

    The presence of light areas in the tubes - "adhesions of the fallopian tubes."

    The shape of the fallopian tubes, resembling the shape of smoking pipes, the presence of extensions in them in the form of a flask, a decrease in the volume of the uterine cavity - the diagnosis is "tuberculosis of the genital organs."

    Uneven contours of the uterus, the detection of defects of an oval or other shape - the diagnosis is "uterine polyps" or "endometrial hyperplasia".

Of course, only the most obvious and common signs of certain diseases were listed. Only the attending physician can make a final diagnosis, evaluating the whole range of results obtained in the course of various studies.

Cons of the GHA

The disadvantages of the procedure are the following points:

    A woman receiving a dose of radiation, albeit a small one.

    The likelihood of an allergic reaction to the injected contrast agent. Particular care should be taken by women with a history, as well as allergic patients.

    There is a risk of mechanical damage to the epithelial layer of the uterus, which leads to the appearance of bleeding.

Advantages of the HSG

In addition to the fact that X-ray HSG is highly informative, it has another important advantage. The fact is that hysterosalpingography is not only a diagnostic, but also a therapeutic method of influencing the female body. It has been established that approximately 20% of women suffering from infertility successfully become pregnant after undergoing HSG.

Doctors explain this fact by the fact that during the procedure it is possible to improve the patency of the fallopian tubes, since the injected substances “wash” them, getting rid of small adhesions.


Education: Diploma "Obstetrics and Gynecology" received at the Russian State Medical University of the Federal Agency for Health and Social Development (2010). In 2013, she completed her postgraduate studies at the NMU. N. I. Pirogov.

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