As part of our commitment to providing comprehensive care to patients undergoing evaluation and treatment of infertility, OIA proudly host the X-ray dye test known as a hysterosalpingogram (HSG)
What is an HSG Test?
The HSG test is an integral part of an initial infertility evaluation. The test determines if a woman’s fallopian tubes are open and evaluates the uterus to rule out the presence of abnormalities including, fibroids, polyps, congenital anomalies, or scar tissue.
Even women who intend to undergo IVF may need this test, as it has been shown that certain types of tubal blockage, as well as the uterine conditions mentioned above can significantly lower success rates.
The test involves inserting a soft balloon-tipped catheter into the uterus. With fluoroscopic visualization, iodine-based dye is slowly injected into the uterus. The dye outlines the shape of the uterus, revealing any structural abnormalities that might be present. The dye then enters the tubes, hopefully showing that they are open (patent).
Who performs the HSG test?
The test is usually performed by a radiologist, often in a hospital setting. While they do a fine job, this can be a cold and impersonal experience for the patient.
On occasion, the radiologist may have difficulty inserting the soft catheter through the cervix, which can be painful or result in cancellation of the procedure. At OIA, the test will be performed by one of our certified reproductive endocrinologists.
Is sedation necessary or available for this test?
Some women experience some pain from the manipulation of the cervix and the distension of the uterus. Unfortunately, the pain from the uterus cannot be totally eliminated, but it is short in duration, and for most it is the equivalent to a strong menstrual cramp.
For women who are concerned about this, or have had a previously difficult experience with the test, conscious sedation can be provided by licensed anesthetists is available for a small additional fee.
WHO NEED IVF?
In many situations in which a couple is experiencing infertility, OIA fertility doctors can treat the problem with first-line fertility treatments such as ovulation induction or intrauterine insemination (IUI). In other cases, the condition causing infertility is treatable with surgery for the male or the female.
For women in whom first-line fertility treatments have been unsuccessful or who have other situations or conditions, in vitro fertilization (IVF) may be the treatment of choice.
IVF was originally developed for women with tubal factor infertility (non-functioning fallopian tubes); however, because of major advances in in vitro fertilization, IVF is not always the treatment of last resort. In fact, it is often the first-line treatment.
Some common female infertility indications for IVF treatment include:
- Fallopian tube damage
- Unexplained infertility
- Age-related infertility
- Being at risk of genetic disease such as cystic fibrosis (IVF with pre-implantation genetic diagnosis — PGD may be indicated
- Infertility or recurrent pregnancy loss related to chromosomal abnormalities — IVF with PGD or pre-implantation genetic screening may be indicated
IVF is often the treatment of choice for couples in who are experiencing male factor infertility, particularly with intracytoplasmic sperm injection (ICSI), a procedure in which one sperm is injected directly into the egg.