To investigate the cause of delayed fertility, the health of the reproductive organs must be evaluated. One of the diagnostic methods requested to examine the uterus and fallopian tubes is hysterosalpingography (HSG). With this test, the physician becomes informed about the internal condition of the uterus and fallopian tubes, and based on the test results, a decision will be made regarding the treatment approach. Performing an HSG is very important in the assessment of infertility.
Applications of Hysterosalpingography (HSG):
Diagnosis of the cause of infertility: One of the most important reasons for performing HSG is to investigate blockage in the fallopian tubes, which can prevent the sperm from reaching the egg, and thus prevent pregnancy.
Investigation of intrauterine adhesions: Intrauterine adhesions may result from previous surgeries, infections, or endometriosis and can cause fertility problems.
Assessment of the shape and size of the uterus: HSG helps the physician assess the shape and size of the uterus and identify any abnormalities.
Detection of tumors or polyps in the uterus: This method can assist in identifying small tumors or polyps in the uterus.
How Hysterosalpingography (HSG) is Performed:
- With local anesthesia, involving minimal pain
- With general anesthesia administered by a female specialist physician
Given that hysterosalpingography causes pain and discomfort in some women, and some individuals avoid undergoing it while awake due to fear or anxiety, PartoTeb Azma Center, as the only HSG center in Iran since 2005, has provided the option of performing this imaging procedure under general anesthesia. Anesthesia is administered by an anesthesiologist, and it is at a level such that the patient will not feel the pain or discomfort of the HSG. Compared to surgical anesthesia, this is much milder. The anesthesia is safe and, with proper care, has no side effects. Furthermore, the presence of the husband or a close male relative is mandatory during the procedure under general anesthesia.
One additional advantage of general anesthesia during HSG is the absence of pelvic muscle contractions and reduced resistance to the placement of instruments into the vagina; which leads to fewer images being required (i.e., lower radiation exposure), and a reduced amount of contrast dye needed. Moreover, in some cases, the fallopian tubes may not open due to spasms caused by anxiety or pain. Under general anesthesia, such spasms are eliminated, and the contrast dye passes more easily through the tubes.
At PartoTeb Azma, with a brief anesthesia, we have turned what was once a nightmare into a good memory for women undergoing uterine imaging…
Important Considerations:
1. You must be examined beforehand so the physician can ensure there is no uterine infection.
2. It must be confirmed that you are not pregnant at the time of imaging.
3. The best time for HSG is after menstruation and before ovulation (i.e., Day 10 of the menstrual cycle).
4. Because stool and intestinal gas can obscure imaging, a laxative may be prescribed for the night before or the day of the test, so the uterus and tubes can be seen more clearly.
5. There is a 1-3% risk of pelvic infection after the procedure. Therefore, you may be prescribed antibiotics as a preventative measure.
Steps of Performing Hysterosalpingography (HSG):
1. You may be asked to wear a medical gown or robe specific to the facility. Remove any metallic objects.
2. You will lie on a fluoroscopy table in the same position used during a gynecological exam. A speculum will be inserted to expose the cervix. Then, a thin catheter will be inserted into the cervical canal. The speculum is removed, and the patient is placed in a comfortable position. Contrast dye is then injected through the catheter into the uterus. When the catheter is inserted and the contrast dye is injected, you may feel some pain or cramping in your lower abdomen — similar to menstrual cramps, though this is temporary and short-lived.
3. At this stage, the radiologist assesses whether the fallopian tubes are open or blocked, based on the images seen on the monitor. The entire procedure takes about 30 minutes.
Additional Notes:
1. You may take an anti-inflammatory painkiller one hour before the test. Often, the unfamiliarity of the patient with the tools and setting causes fear and discomfort. We hope that, with these explanations, you will be more comfortable and informed.
2. Spotting for a few days after the test is common and normal.
3. In some cases, a previously blocked fallopian tube may open after the procedure, and pregnancy may occur in that same month.
It should be noted that the imaging is performed by a female technician.
Anesthesia-assisted HSG is only offered three days a week, with only 10 patients accepted per day.
Additionally, MRI, CT-Scan under anesthesia, and myelography are performed at this center by anesthesiologists.
* Images are delivered in a maximum of 15 minutes. *
For further information, you may contact the female anesthesiologist between 9 AM to 12 PM and 4 PM to 8 PM.
For answers to frequently asked questions about hysterosalpingography, please call the numbers below.
To ease the process (especially for women from other cities), telephone registration is available, and there is no need to visit in person.
Contact Number:
[+98] 25-3119, Extension 812
