Hysterosalpingogram

Excerpt

Hysterosalpingogram (HSG) is an imaging procedure in which contrast dye is injected into the uterine cavity, progresses into the fallopian tubes, and ultimately reaches the fimbriated ends adjacent to the ovaries. Fluoroscopy and x-ray images are taken at various stages of the procedure to assess filling, uterine shape, tubal patency, and peritoneal spillage to evaluate the structure of the endometrial cavity and patency of the fallopian tubes. This diagnostic modality is primarily utilized in assessing female infertility. Structural endometrial cavity and fallopian tube abnormalities contribute significantly to infertility, with up to 60% of cases attributed to such issues.

The ability to specifically evaluate fallopian tube patency and endometrial cavity structure is unique to HSG, which is often utilized as a complementary procedure with other imaging modalities (eg, pelvic ultrasonography, hysteroscopy, or magnetic resonance imaging) to assess anatomic infertility etiologies. Advancements in contrast agents have improved the safety and tolerance of HSG, with modern nonionic, iso-osmolar agents offering enhanced patient comfort. HSG has some contraindications and associated complications; however, the procedure remains a cornerstone in the diagnostic evaluation of female infertility. Therefore, clinicians should understand how to integrate the HSG procedure into an infertility evaluation, ensuring optimal patient care and accurate interpretation of results.