If you are trying to conceive but struggling, you may be considering what investigations to ask your doctor for and you may have heard other women talking about a procedure called a HSG. A HSG (or Hysteroscopy) is one way of assessing if there are any blockages in your fallopian tubes.
The Fallopian tubes pay a very important role in conception. After ovulation, the egg released from the ovary meets the sperm in the fallopian tube where fertilisation takes place. The embryo that forms at fertilisation then travels along the fallopian tube to the uterus for implantation. If one or both fallopian tubes are blocked this can make conceiving naturally difficult or completely impossible.
Do I need a HSG?
If you are under 35 and have been trying to conceive for 1 year or over 35 and trying to conceive for 6 months, advisable to ask your doctor for a referral to check your tubes are patent. This can be done in one of three ways: Hysterosalpingography (HSG), Hysterosalpingo-contrast-ultrasonography (HyCoSy), or Laparoscopy and Dye test
Women with no known previous sexually transmitted infections or pelvic inflammatory disease, previous ectopic pregnancy or endometriosis are generally offered a HSG or HyCoSy. Women who are suspected to have any of the above comorbidities would be offered a laparoscopy and dye so that other pelvic problems, such as scar tissue (adhesions) or endometriosis, can be assessed and, if appropriate, treated at the same time.
What is a HSG?
HSG is a day case procedure usually done within 10 days of the start of your period. A small tube is passed through the neck of the uterus (cervix) into the uterine cavity. A dye is then introduced which flows through the tube into your womb cavity and a series of X-rays are taken.
The procedure can cause a bit of discomfort but most women tolerate the procedure well. There is a very small risk of infection spreading from the vagina up into the pelvis and therefore screening for infections is offered before the procedure or you will be given antibiotics. HyCoSy is similar to HSG, but the flow of dye is followed by ultrasound scan as opposed to X-ray.
A laparoscopy and dye test is minor surgery usually performed as a day case procedure under general anaesthesia. A small cut (1cm) is made in the abdomen and a small camera (the laparoscope) is then passed through the cut. Dye is then passed through the cervix and watched as it fills and then spills from the fallopian tubes providing they are open. The choice of test depends upon your previous history and each test has its own advantages and disadvantages.