An HSG (hystersalpingogram) is an X-ray of the inside of the fallopian tubes and uterus. This test is sometimes used to help find out why a woman is not becoming pregnant. An OB-GYN and a radiologist generally work together to do this test in a hospital's radiology department.

An HSG can pick up several problems that may prevent pregnancy. The most common is blocked fallopian tubes from old or current pelvic infection. Other problems identified by an HSG include uterine fibroids, a septum or division inside the uterus, or adhesions in the uterus.

An HSG is usually done just after the patient's menstrual period. To help with cramping during the test, pain medication such as Ibuprofen or Tylenol may be used 1-2 hours before the test. Your doctor may  prescribe an antibiotic just before or after the test to help prevent infection.

The actual test involves being positioned as you would be during a Pap test. A speculum is used to see the cervix. A thin tube is placed just inside the cervix while dye is pushed into the uterus through the tube. X-rays are taken as the dye is pushed through the tube. You may be able to watch the progress of the dye on the X-ray monitor. The test usually takes about 10-20 minutes.

Most women can return to work right after the HSG. Cramping and discharge for a few hours is common and pads (not tampons) can be used for this discharge. You should call your doctor if you have a fever greater than 100 degrees F or have increasing lower abdominal pain after the test.

HSG  is also used to confirm that an ESSURE has successfully blocked both fallopian tubes for desired sterilization.  In this case, HSG is done three months after the procedure.