To diagnose whether the fallopian tubes are clear or blocked, an out patient procedure is done which gives clarity about the internal cavity of uterus, fallopian tubes internal condition and presence of any fibroids or any scar tissue.

This procedure is generally recommended to patients who have all hormone tests for both partners normal but not able to get pregnant naturally or by hormonal therapy. It is also recommended to patients with history of abortions, endometriosis and miscarriages.

The procedure includes insertion of a catheter into vagina till the opening of cervix and with the help of a syringe a dye is injected into the uterus which travels through fallopian tubes and is monitored through fluorescent X-ray. The time or rate at which the dye spills out through the ovary end of fallopian tube into pelvic cavity helps in assessing the percentage of blockage in the fallopian tubes. If the dye spills out fastly then there is no blockage, if it is slow then there is blockage.

If blockage is found then again an oil based contrast medium is injected through cervix and tubual flushing is done. If the blockage is of less percentage then it will be cleared. If the blockage is more, then it has to be cleared with laparoscopy.  

Advantages of HSG

1. Tubual blockage clearance increases chances of pregnancy by 50%.
2. Improves uterine lining to hold the growing embryo.
3. Improves fertilization rate and helps in natural pregnancy.

Disadvantages of HSG

1. This procedure may harm the growing embryo if already pregnancy is confirmed so should make sure that patient is not pregnant.
2. If the procedure is not done using sterile instruments and well trained radiologist then there will be a chance of infection.

Precautions:

1. After the procedure, bleeding and tissue discharge is observed which if is less in quantity  then it is normal.
2. If the bleeding and tissue discharge with pain is more, then have to report to doctor immediately.
3. This procedure is painful and depending upon the percentage of blockage, pain varies. So it is done by giving mild anesthesia to patient. Even then during the procedure pain occurs which also helps radiologist to assess to intensity of blockage.
4. Use sanitary pads when bleeding occurs after HSG test to avoid infection. Do not use tampons.