Hysterosalpingogram (HSG)

Indication and procedures

HSG is one of the screening tests used in investigating subfertility problem. It is a X-ray examination using contrast medium which infiltrate into your womb in order to check for any uterine cavity abnormality and whether your fallopian tubes are patent or not. During the procedure, a vaginal speculum will be used and a tiny tubing will be inserted into your womb for contrast infiltration. X-ray photos will then be taken for further assessment. However, HSG cannot assess the abdominal or pelvic region for any pelvic-peritoneal pathology such as adhesion (caused by previous pelvic operation/infection) or pelvic endometriosis, so it is only suitable for patients who are at low risk of these problems.

Contraindications

You should not have HSG examination if you are having active genital tract infection or you are pregnant now.

Special precautions

1. If you have any allergic history (e.g. food/alcohol/drug/contrast medium allergy, history of urticaria/eczema/asthma/allergic rhinitis/hay fever) or any cardiac disease, please inform your doctor as you may need steroid drug before HSG in order to minimize your risk of contrast reaction.

• If you are indicated to have steroid drug, please take 40 mg Prednisolone by mouth 12 hours before and another 40 mg Prednisolone orally 2 hours before your HSG appointment.

2. If you have diabetes, polycystic ovarian syndrome (PCOS) or any other reasons which need to take Metformin currently, please inform your doctor as a special drug instruction is needed.

• You need to stop Metformin 24 hours before your HSG appointment until 48 hours after the examination. You can resume the drug as usual afterwards.

3. To avoid chance of undetectable early pregnancy during the procedure, please abstinence from sexual activity after your last menstrual period (the one just preceding HSG) till the examination day.

Adverse reaction and complications

HSG does not require any anaesthesia but you may experience some distension-like discomfort or mild pain during the procedure. Uncommon but possible complications include vaginal bleeding, pelvic infection, uterine perforation and contrast allergic reaction etc. Please inform medical staff immediately if you have any discomfort during the procedure.

Post-HSG advice

You may have minimal vaginal spotting and abdominal discomfort for few days. But if the discomfort persists or getting severe, or associates with foul smelling vaginal discharge or fever, please seek medical advice as soon as possible.