Hysterosalpingography

Hysterosalpingography (HSG) is a radiologicprocedure to examine the uterusand fallopian tubes. It entails the injection of a radio-opaque material into the cervicalcanal and usually fluoroscopywith image intensification. A normal result shows the filling of the uterine cavity and the bilateral filling of the fallopian tube with the injection material. To demonstrate tubal patency spillage of the material into the peritoneal cavityneeds to be observed.

The procedure involves ionizating x-raysand should be done in the preovulatory phase of the cycle; it is contraindicated in pregnancy. The procedure was introduced in 1910. It is useful to diagnose uterine malformations, Asherman's syndrome, tubal occlusionand used extensively in the work-up of infertilewomen. It has been claimed that pregnancy rates are increased in a cycle when an HSG has been performed. Using catheters, an interventional radiologist can open tubes that are proximally occluded.

Complications of the procedure include infection, allergicreactions to the materials used, intravasationof the material, and ,if oil-based material is used, embolisation.

References

Baramki TA. Hysterosalpingography. Fertil Steril 2005;83:1595-606.

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