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Hysterosalpingogram (HSG) - Testing for Uterine Factors in Recurrent Miscarriage

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Updated April 04, 2010

What a Hysterosalpingogram Is:

In short, a hysterosalpingogram (or HSG) is a test that involves injecting dye into the uterus and fallopian tubes and then taking an x-ray in order to get a visual image of any abnormalities.

Why a Hysterosalpingogram Is Used in Recurrent Miscarriages:

In women with recurrent miscarriages, the test is used to screen for problems with the uterus that might increase risk of miscarriage. HSG is also used for women with infertility to look for blocked fallopian tubes or other infertility risk factors.

What Happens During a Hysterosalpingogram:

The woman is asked to disrobe from the waist down and lie down with her feet in stirrups or otherwise elevated. The doctor (or technician) inserts a speculum in order to see the cervix, then places a tube through the opening in the cervix. The doctor or technician then injects dye through the tube and takes a series of x-rays as the dye travels through the uterus and fallopian tubes. The woman may be asked to change positions. The entire procedure takes 5 to 10 minutes.

Risks and Side Effects of a Hysterosalpingogram:

Most women have mild to moderate cramping for about five minutes following the test, as well as mild spotting for one or two days.

Rarely, some women may have allergic reactions to the iodine dye used during an HSG. An HSG also carries a minor risk of infection, particularly in women who have had multiple sexual partners.

How a Doctor Uses Results from a Hysterosalpingogram:

The HSG generates an image of the uterus and fallopian tubes. This image is then analyzed by the doctor for signs of the following problems (which can be factors in miscarriages):

  • Congenital problems with the uterus (such as a septum)
  • Scar tissue in the uterus
  • Fibroids
  • Polyps

If these problems are detected, the doctor may suggest following up with a hysteroscopy or other minor surgery to treat the issue.

A few studies have found higher fertility in up to three menstrual cycles following an HSG, although the reason for this has not yet been explained.

Sources:

Advanced Fertility Center of Chicago, "Hysterosalpingogram - HSG." 2007. Accessed 30 Nov 2007.

American Society for Reproductive Medicine, "Patient's Fact Sheet - Hysterosalpingogram (HSG)." May 2003. 30 Nov 2007.

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