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If a woman is trying to conceive a baby then you must know that there are many parts of reproductive system that are responsible for conception and these should be healthy, like for example in woman ovaries needs to produce an egg every month, that is called ovulation, uterus has to be free from any kind of abnormality like fibroid, adenomyosis, polyp etc. and lastly fallopian tubes that are connected bilaterally to the uterus should be open and healthy as well.

If any one of these reproductive parts in women isn’t functioning properly, a woman might have trouble in getting pregnant.
Fallopian tubes are connected to the uterus and when egg is released from the ovary at the time of ovulation then the egg and sperm both get fertilized in the fallopian tube after than an embryo will develop and continue through the fallopian tubes until it reaches the uterus, where it will implanted into the uterine lining. So if fallopian tubes are blocked or unhealthy than, either there will be no fertilization or embryo will not survive in tube.

Blocked tubes can happen due to different reasons, but no matter what the cause, your doctor will diagnose it with a test called hysterosalpingogram (HSG).

WHY DO I NEED A HYSTEROSALPINGOGRAM (HSG)?
The hysterosalpingography is performed for the patients that are having difficulty in conceiving in spite of regular intercourse for a period of 1 or 2 year because it is a test that not only can confirm that a woman’s fallopian tubes are open, but can also assess whether the uterine cavity is normal. It is an opd procedure in which the test takes no longer than a10 minutes. It involves placing an iodine-based dye through the uterus mouth called cervix and taking x-ray. These x-ray help evaluate the inside shape of the uterus along with the fallopian tubes are status.

HSG should be done within 5 days of finishing your period. This is to reduce the risk of having undiagnosed pregnancy when test is being done.

On the day of the test, doctor may advice some painkiller an hour before you are going for HSG.so that it can help with the discomfort of the test. Also, some antibiotics are advised to reduce the risk of infection.

THE HSG PROCEDURE
At the start of the procedure, a speculum is inserted into the vagina in order to view the cervix, similar to a Pap smear. The cervix is cleaned with an antiseptic solution; then, a thin, plastic catheter, generally about the size of the tip of a pen, is placed inside the cervix. Once placed an iodine-based dye is then injected through the catheter. This goes through the uterus, into the fallopian tubes unless they are blocked, and out into the pelvic cavity. This is what enables the radiologist to see the shape of the uterus and detect any blockages.

The process involves the specialist X-ray known as fluoroscopy. The uterus and fallopian tubes are filled with fluid containing a dye which can be detected by an X-ray machine, enabling the radiologist to see the inside of these organs via a TV-like monitor.

IS THERE ANY RISK IN HSG?
This is generally a very safe procedure but there are rare risks. There is a possibility of infection in only one per cent of cases, or a very rare allergic reaction to the iodine used.

IS HSG PAINFUL?
Many women wonder if the hysterosalpingography (HSG) test will cause pain. The experience of HSG is different for every woman some women only have mild cramps, while some may complain of excruciating pain especially if tubes are blocked. If you are very much scared of pain you may request it to be done under short general anesthesia .even if there is pain, it is short testing you may also have some spotting. You are also free to resume your day to day normal activities.

What Do the Results Mean?
The HSG helps the doctor check out two important factors:

1-The fallopian tubes are blocked – If the fallopian tubes are blocked, a woman will not be able to get pregnant, because the egg can’t meet the sperm.

2-The fallopian tubes are open-if the tubes are open then the women can conceive through naturally timed intercourse or if needed then through IUI (INTRAUTERINE INSEMINATION).

3- The inside shape of the uterus is normal or not- if the shape of the uterus is not looking perfect then it may be considered the cause in some women with recurrent pregnancy loss. This test may suggest to go for hysteroscopy to look inside the uterus and correct defects like septum if present.

Are there other options?
Laparoscopy can also identify if tubes are open, using a procedure called chromopertubation. Sonohysterosalpingogram (SHG) is an alternative procedure to evaluate tubal patency with the help of ultrasound rather than x ray but laparoscopy is a surgery under general anesthesia and sonohysterosalpingography is also performed just like HSG with similar discomfort involved.