A hysterosalpingogram is an x-ray of the uterus and fallopian tubes which allows visualization of the inside of the uterus and tubes. The picture will reveal any abnormalities of the uterus as well as tubal problems such as blockage and dilation (hydrosalpinx). If sterilization reversal is planned, the point at which the tubes are blocked can be seen. This helps to plan the reconstructive procedure.
If the tubes are not blocked by scar tissue or adhesions, the dye will flow into the abdominal cavity. This is a good sign but it does not guarantee that the tubes will function normally. It does give a rough estimate of the quality of the tubal structure and the status of the tubal lining. Some cases where the tubes appear to be blocked where they join the uterus, may in fact be normal. Often blockage at this location may be due to spasm of the opening from the uterus into the tube or from accumulated debris and mucus blocking the opening. This can be managed by passing a very thin catheter into the fallopian tube either at the time of hysterosalpingogram or during a hysteroscopic procedure.
Generally there is no special preparation needed for this test. However, before the exam, it is recommended that you tell your doctor if you:
- Are or might be pregnant.
- Currently have a pelvic infection (pelvic inflammatory disease) or sexually transmitted disease (such as gonorrhea or chlamydia).
- Are allergic to the iodine dye used or any other substance that has iodine. Also tell your doctor if you have asthma, are allergic to any medicines, or have had a serious allergic reaction (anaphylaxis) from any substance (such as the venom from a bee sting or from eating shellfish).
- Have any bleeding problems or are taking any blood-thinning medicines, such as aspirin or warfarin (such as Coumadin).
- Have a history of kidney problems or diabetes, especially if you take metformin(such as Glucophage) to control your diabetes. The dye used during a hysterosalpingogram can cause kidney damage in people with poor kidney function. If you have a history of kidney problems, blood tests (creatinine, blood urea nitrogen) may be done before the hysterosalpingogram to check that your kidneys are working well.
A hysterosalpingogram is often not covered by insurance, as it is may be considered an elective examination. However, Capitol Imaging Services performs hysterosalpingograms at a price that is hundreds of dollars less than local hospital imaging centers.