Home › HSG test: how your tubes are checked
HSG test: how your tubes are checked
An HSG (hysterosalpingogram) is a short X-ray study of the womb and the fallopian tubes. A contrast fluid is placed in the womb through a fine catheter, and X-ray images follow where it goes: if it flows out of the far ends of the tubes, they are open. From start to finish it takes roughly 10 to 15 minutes.
Why check the tubes at all?
Fertilisation happens inside a fallopian tube. If neither tube is open, the egg and the sperm cannot meet, and treatments such as IUI cannot work. Most women with a tubal block feel completely well, so only a test can show it. The risk is higher after an earlier infection of the womb or tubes (including tuberculosis), after an operation on the tummy, or with endometriosis.
Which cycle days suit an HSG?
The usual window is roughly day 6 to day 11, counting the first day of bleeding as day 1: the period has finished and ovulation has not yet happened. This makes an early pregnancy very unlikely at the time of the X-ray; tell the doctor if your period was late or unusual. The test is not done in pregnancy or while a pelvic infection is active.
How to prepare
- Note the date your last period started, and bring any earlier reports.
- Tell the team beforehand if you have ever reacted to X-ray contrast or iodine, or if you might be pregnant.
- Take a painkiller before the test only if your doctor advises it.
- You may like someone to come with you, although most women travel home on their own.
Step by step
The position is the same as for a Pap smear; an instrument gently opens the vagina to bring the cervix into view. A fine plastic catheter sits at the opening of the womb, and the contrast fluid is let in slowly. X-ray images are taken as the fluid outlines the womb and travels along each tube. No hospital stay is needed.
How does it feel?
Expect a crampy ache, similar to a heavy period day, for the short time the fluid is flowing; it usually eases within minutes to a few hours. Some women notice slight bleeding or a watery discharge for a short while afterwards; this is expected.
Reading the result
- Fluid spills from both tube ends: both tubes are open.
- No spill on one or both sides: a possible block. A tube that briefly tightens during the test may not fill even though it is open, so the result is read with the rest of the picture.
- An irregular outline of the womb: it may point to a polyp, fibroid, septum or adhesions, which a hysteroscopy can look at directly.
After the result
If the tubes are open, IUI and other simpler treatments remain possible. If only one tube is blocked, the doctor will advise whether IUI is still suitable. If both tubes are blocked, a laparoscopy may confirm and sometimes treat the cause, or IVF may be advised, since IVF works without the tubes. HSG is one of several fertility tests for couples, and the husband's semen analysis is done alongside it.
Other ways to check the tubes
An HSG is usually the first test, because it is quick and is done without anaesthesia. If X-rays are better avoided, the tubes can be checked by ultrasound instead: in a sono-HSG, also called HyCoSy, fluid is passed into the womb while the scan watches whether it flows through. When there is also a reason to look inside the pelvis, for example to look for endometriosis or adhesions, a laparoscopy lets the surgeon pass dye through the tubes, see them directly and often treat what is found in the same operation. Which of these is right for you is decided with your doctor after looking at your history.
Allergy, infection and pregnancy precautions
- Tell the team if you have ever reacted to X-ray dye or iodine.
- Tell them if you have pelvic pain, an unusual discharge or a past pelvic infection; an infection is treated before the test.
- The test is planned in the days after your period ends and before ovulation, so a pregnancy in that cycle is very unlikely; tell the team if your period was late or unusual.
When to call your doctor
Fever, heavy bleeding, severe or worsening pain in the lower abdomen, or a smelly discharge in the days after the test need prompt care; they can be signs of infection or another problem.
Common questions about the HSG test
Does an HSG hurt?
There is usually a crampy ache, like a strong period day, that eases within minutes to a few hours. A painkiller beforehand, if your doctor advises it, helps.
Which cycle days suit an HSG?
Roughly day 6 to day 11, counting the first day of bleeding as day 1: after the bleeding stops and before ovulation, so an early pregnancy is very unlikely at the time of the X-ray.
Do I need an HSG before IUI?
Usually yes. IUI only places the sperm higher up; fertilisation still happens in a tube, so at least one tube has to be open.
Would I know if my tubes were blocked?
Usually not. Most women with a tubal block feel completely well, so only a test can show it.
What if the HSG suggests a block?
A tube that briefly tightens during the test may not fill even though it is open, so the result is read with your other reports. Depending on the cause, a laparoscopy may be advised, or IVF, which works without the tubes.
How soon can I get back to work?
Daily routine and office work can usually resume by the following morning, often sooner. Avoid intercourse while there is spotting, and call your doctor if you get a fever, heavy bleeding or severe pain.
Is there a test of the tubes without X-rays?
Yes. A sono-HSG (HyCoSy) checks the tubes with ultrasound, and a laparoscopy with dye checks them during keyhole surgery.
Your visit is confidential — nothing about you appears on this website or on social media.
What you read here explains fertility care in general terms and cannot replace a consultation. Decisions about your own care should be made with a doctor who knows your history and has seen you. We do not carry out or offer sex determination of any kind, which is prohibited by law in India under the PCPNDT Act.