See what's blocking conception.
A quick X-ray test that maps your fallopian tubes and uterine cavity in one visit.
Overview
A hysterosalpingogram, almost always shortened to HSG, is an X-ray study that maps the inside of the uterus and shows whether the fallopian tubes are open. A fine catheter is passed through the cervix and an iodine-based contrast dye is slowly instilled. Because the dye is visible on X-ray, we can watch in real time as it fills the uterine cavity and then spills out of each tube into the abdomen.
Two questions get answered in that one short study. First, the shape of the uterine cavity — whether there is a septum, adhesions, polyps or fibroids distorting the space an embryo would need to implant in. Second, tubal patency, meaning whether sperm and egg can physically meet at all. Blocked tubes are a common and completely silent cause of infertility; there are no symptoms, and nothing on an ultrasound will reveal them.
The test is timed deliberately to days six to eleven of the cycle: after bleeding has finished, so the view is clear, but before ovulation, so there is no risk of disturbing an early pregnancy. The whole appointment takes about fifteen minutes, needs no anaesthesia, and you can drive yourself home afterwards.
Most women feel cramping similar to strong period pain during the moments the dye is injected, easing within minutes. A simple painkiller taken about an hour beforehand makes a noticeable difference. Light spotting for a day or two afterwards is normal and expected.
There is a well-documented and welcome side effect. The pressure of the dye can flush out mucus plugs and minor debris, and studies have consistently shown a modest rise in natural conception rates in the two to three months immediately following an HSG — particularly when oil-based contrast is used. It is a diagnostic test that occasionally treats the problem it was sent to find.
What Happens During the Test
Timing and Preparation
Booked for day 6 to 11 of your cycle. Take a simple painkiller about an hour before you arrive.
Positioning
You lie on an X-ray table much as you would for a routine smear. A speculum is passed to visualise the cervix.
Catheter Placement
A very fine catheter is guided just inside the cervical canal. No incision and no anaesthesia are involved.
Contrast Injection
Iodine-based dye is instilled slowly. This is the point at which cramping is felt, and it lasts under a minute.
Live Imaging
X-ray images are taken as the dye outlines the cavity and then spills from each tube into the abdomen.
Going Home
The speculum is removed and you rest briefly. No sedation is used, so you can drive yourself home.
What the Results Actually Mean
Both tubes open
Sperm and egg can meet. Attention shifts to ovulation, sperm quality, or the uterine lining.
One tube blocked
Natural conception and IUI remain possible through the open side, often with timed monitoring.
Both tubes blocked
IVF is the clear route, because it bypasses the tubes completely rather than trying to repair them.
Hydrosalpinx
A fluid-filled, swollen tube. This fluid lowers IVF success and is usually treated before any transfer.
Filling defect in the cavity
Suggests a polyp, fibroid or adhesion. Hysteroscopy both confirms and treats it in one sitting.
Uterine septum or abnormal shape
A congenital variation in cavity shape, which may be correctable surgically where it affects implantation.
Key Benefits
- Clear diagnostic imaging
- Quick outpatient procedure
- Can flush out minor blockages
- Guides future treatment plans
Start With a Clear Picture
An HSG gives us the clarity to recommend the right next step — timed intercourse, IUI, or IVF.