A Hysterosalpingogram (HSG) is usually done as part of an infertility evaluation for a woman of childbearing age. The radiologist introduces a speculum into the vaginal cavity to visualize the cervix. The cervix is cleaned with a Betadine preparation and then a thin catheter is inserted through the cervical canal into the endometrial cavity.
The procedure can be used to investigate repeated miscarriages that result from congenital or acquired abnormalities of the uterus and to determine the presence and severity of these abnormalities, including:
- tumor masses
- uterine fibroids
Hysterosalpingography is also used to evaluate the openness of the fallopian tubes, and to monitor the effects of tubal surgery, including:
- blockage of the fallopian tubes due to infection or scarring
- tubal ligation
- the closure of the fallopian tubes in a sterilization procedure and a sterilization reversal
- the re-opening of the fallopian tubes following a sterilization or disease-related blockage
A small balloon at the end of the catheter is inflated in the endometrial cavity to provide a good seal.
Under fluoroscopic observation, the radiologist injects a small amount of water-soluble contrast (15-20 cc), which fills the endometrial cavity of the uterus and both fallopian tubes. The tubal anatomy and patency can be assessed. Normally, the tubes are slender and spill freely into the peritoneal cavity.
This exam must be performed between the 7th and 10th day of a woman’s menstrual cycle. Day one is the day menstruation begins. Women should also abstain from sexual intercourse from the onset of menstruation until the completion of the exam.
Diagnostic Imaging Services also performs the Essure Confirmation Test. Essure is permanent birth control completed with a non-surgical procedure.
The Essure Confirmation Test with a modified HSG is used to evaluate the location of the inserts and occlusion of the fallopian tubes. Every patient must have an Essure Confirmation Test three months following the Essure insert placement procedure. The patient must use alternative contraception (except an IUD or IUS) until the Essure Confirmation Test verifies satisfactory location and bilateral occlusion.