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Hysterosalpingogram (HSG): What to Expect

If your doctor has just recommended that you have a hysterosalpingogram (HSG), you may feel worried or overwhelmed. Here are some of the essential facts about this routine test.


A hysterosalpingogram (HSG) is an X-ray test that looks at the inside of the uterus and fallopian tubes and the area around them. It is an outpatient procedure that usually takes less than 30 minutes to perform.

During the test, you may feel some cramping like menstrual cramps. After the HSG, a woman can immediately resume normal activities, although some doctors may ask that she refrain from intercourse for several days.


An HSG is often done in women who are having difficulty becoming pregnant. The test may identify mechanical factors contributing to infertility, which include scarred or blocked fallopian tubes and hydrosalpinx.


An HSG should be performed 2 to 5 days after your menstrual period has ended to ensure you are not pregnant. It should also be done before you ovulate the next month — unless you are using contraception — to avoid using X-rays during an early pregnancy. The test cannot be done while you are having a pelvic infection.


A radiologist typically performs the HSG, in the X-ray room of a hospital or clinic. A radiology technologist and a nurse may help the doctor perform the test. A gynecologist or a reproductive endocrinologist (doctor specializing in infertility) may also assist.


During a hysterosalpingogram, a thin tube is inserted into the uterus, through the vagina, and is used to fill the uterus with iodine dye (contrast material). Because the fallopian tubes are connected to the uterus, the dye will flow into the fallopian tubes. X-ray beams (fluoroscopy) take pictures as the dye passes through the uterus and fallopian tubes.

These images can show problems such as an injury or abnormal structure of the uterus or fallopian tubes. They can also identify blockages that may prevent an egg from moving through a fallopian tube to the uterus. A blockage can also prevent sperm from moving into a fallopian tube and joining with the egg (fertilization). If the fallopian tubes are free of blockages, the dye outlines the length of the tubes and spills out of the ends.

Learn about our non-surgical treatment for blocked fallopian tubes.


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