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Hysterosalpingography (HSG) is a specialized X-ray procedure used to examine a woman’s uterus and fallopian tubes to assess their shape, structure, and patency (openness). It is most commonly performed in cases of infertility or recurrent miscarriages, to detect abnormalities such as blockages, adhesions, uterine fibroids, polyps, or congenital uterine anomalies. During the procedure, a contrast dye (usually iodine-based) is gently introduced into the uterine cavity through the cervix using a thin catheter. As the contrast fills the uterus and flows through the fallopian tubes, fluoroscopic X-ray images are taken in real-time to track the passage of the dye. If the fallopian tubes are open, the dye spills out into the abdominal cavity, confirming tubal patency. If the tubes are blocked, the contrast will stop or fill only partially. The procedure is typically done between the 7th and 10th day of the menstrual cycle, after menstruation but before ovulation, to avoid disturbing a possible early pregnancy. While the procedure is quick, often taking about 15–30 minutes, it may cause mild cramping or discomfort as the dye enters the uterus and tubes. HSG not only serves a diagnostic purpose but, in some cases, may have a therapeutic benefit, as the dye can sometimes clear minor blockages. After the exam, patients may have slight spotting and are advised to avoid intercourse or tampon use for a short period. HSG remains an essential tool in female reproductive health, especially in evaluating tubal factors in infertility.
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