Hysterosalpingography (HSG Tubal Test)

Hysterosalpingography is an X-ray test of the uterine cavity and fallopian tubes. Contrast dye is passed gently through the cervix while X-ray images show whether it fills the uterus, travels along both tubes and spills out freely at their ends.

It is the usual first check of whether the tubes are open in a fertility work-up. It shows the inside outline only, so it cannot see endometriosis, adhesions around the tubes or the ovaries.

What Hysterosalpingography (HSG Tubal Test) shows

A normal study shows a smooth triangular cavity, two thin tubes and dye spreading among the bowel loops. It can reveal a blocked tube near the uterus or at its far end, a swollen fluid-filled tube (hydrosalpinx), polyps, fibroids bulging into the cavity, scar tissue inside the uterus and shape differences such as a septate or bicornuate uterus, which need MRI, 3D ultrasound or hysteroscopy to tell apart. An apparent blockage at the uterine end is quite often a temporary spasm, not true disease.

When Hysterosalpingography (HSG Tubal Test) is recommended

• Couples who have not conceived after 12 months, or 6 months if the woman is over 35
• Before intrauterine insemination, which needs at least one open tube
• History of pelvic infection, ectopic pregnancy, appendix rupture or pelvic surgery
• Recurrent miscarriage, to outline the cavity
• Checking tubal blockage after sterilisation procedures

Limits and situations where another test is better:

• Possible pregnancy, active pelvic infection or heavy bleeding
• Known hydrosalpinx or strong suspicion of endometriosis, where laparoscopy with dye gives more information and allows treatment
• Iodine contrast allergy; ultrasound-based HyCoSy with foam is an alternative without radiation
• Women going straight to IVF may not need tubal testing at all

How to prepare

• Book between day 6 and day 12 of the cycle, after bleeding stops and before ovulation
• Avoid unprotected intercourse from your period until the test
• Take an anti-inflammatory painkiller about an hour before
• Screening swabs or preventive antibiotics may be advised if you have had pelvic infection
• Bring a sanitary pad

What happens during the test

You lie on the X-ray table as for a smear. A speculum is placed, the cervix cleaned, and a thin catheter or small balloon inserted. As dye is injected you feel period-like cramps for a minute or two, stronger if a tube is blocked. A few images are taken with brief X-ray exposure. It takes 10 to 20 minutes and you can leave after a short rest.

Results and next steps

The radiologist or fertility doctor can usually tell you the main finding straight away, with a written report in 1 to 2 days. Open tubes and a normal cavity allow ovulation induction or insemination. Cavity abnormalities lead to hysteroscopy. Blocked or swollen tubes lead to discussion of laparoscopy or IVF, and removing or clipping a hydrosalpinx before IVF improves success.

• Test time: 10 to 20 minutes
• Results ready: Same day; report in 1 to 2 days
• Back to everyday activity: Rest of the day if crampy

Safety and risks

• Cramping and light spotting for 1 to 2 days
• Pelvic infection in about 1 percent, more with previous tubal disease: report fever or worsening pain
• Fainting or feeling light-headed just after the test
• Allergic reaction to contrast, rare
• A low radiation dose to the pelvis

Arranging Hysterosalpingography (HSG Tubal Test) in Türkiye

It is worth doing on a trip only as part of a fertility assessment, and the fixed timing in the cycle has to be planned around your dates. If you already have a recent HSG from home, bring the images; repeating it is rarely needed.

Send your previous reports and the question you want answered and a Clinic-Y coordinator replies within 24 hours with suitable teams and written, all-inclusive proposals side by side. Reviewing your case is free.

Frequently Asked Questions