HSG / HYSTEROSALPINGOGRA

The hysterosalpingogram (HSG) is the standard, basic x-ray study of the uterus. It is designed to evaluate the inside of a uterus (the uterine cavity) and give a crude assessment of whether the fallopian tubes are patent.

When attempting to test for blocked fallopian tubes, a HSG is performed whereby dye is injected into the uterus. If the fallopian tubes are open, the dye will flow through the fallopian tubes at out the ends. Sometimes dye will not flow into the tube(s) because of an obstruction or “spasm” of the muscle around the opening of the tube. With HSG alone, it is impossible to distinguish an obstruction (which is important) from spasm (which is of less importance).

In order to determine if an infertile woman has blocked fallopian tubes, an x-ray test is performed. If blockage of the fallopian tubes is suspected, a catheter may be advanced into the opening of the tube. Through selective salpingography, a blocked tube may be opened. In other cases, selective salpingography alone is insufficient to remove an obstruction, resulting in a need for additional techniques to attempt to achieve a patent fallopian tube. Another technique includes the insertion of a thin, flexible wire, carefully threaded through a selective salpingography catheter and passed directly inside a fallopian tube.

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