There are many reasons why women of childbearing age do not get pregnant. One of these is obstruction of the oviducts. To identify or exclude this patho...

By Masterweb

19.04.2018 06:00

HSG of the fallopian tubes is a relatively new diagnostic method that allows you to identify the causes of possible infertility, the presence of various pathologies and diseases. If a woman of childbearing age does not become pregnant for a long time, the attending physician prescribes HSG, the full name is hysterosalpingography.

Procedure specifics

Hysterosalpingography is a medical method for examining the uterine cavity and the lumen of the fallopian tubes using a contrast agent that is well visualized on an x-ray. This procedure gives a detailed diagnostic picture of some pathologies and diseases with minimal intervention and low concentration of X-rays.

Technique

The tubal HSG procedure is performed under local anesthesia. Narcosis is not applied. The patient is placed on a gynecological chair that does not interfere with x-rays. The position of the body is the same as in gynecological operations. The external genital organs are treated with an antiseptic solution.

First, the doctor conducts a manual examination, after which he examines the cervix with the help of mirrors. Then the gynecologist inserts a tube into the cervical canal, connected to a syringe with a water-soluble contrast agent. The fluid must be warmed up to body temperature to eliminate pain and spasms.

The contrast agent flows under pressure into the uterine cavity and fallopian tubes. This is followed by a series of x-rays. At the end of the hysterosalpingography, the tube is removed. The rest of the contrast fluid flows out through the cervical canal and vagina.

HSG of the fallopian tubes is almost painless. Patients note a slight discomfort that occurs against the background of stretching the uterus with a special liquid. These sensations completely disappear half an hour after hysterosalpingography. At the end of the procedure, the woman is left to lie on the couch for an hour to minimize pain. The radiation load on the body does not exceed the permissible limits, and therefore is safe for the patient. This is possible thanks to the use of modern medical devices.

What substance is used for HSG?

HSG of the fallopian tubes is performed using a special fluid that can absorb x-rays, thereby increasing the contrast of images. During the diagnostic procedure, the following contrasts are used:

• "Cardiotrast" - 30 or 50% iodine solution in ampoules.
• "Verografin", "Urografin", "Triombrast" - contain 60 or 76% iodine.

Interestingly, the first HSG procedure was performed using Lugol's solution. It was back in 1909. However, the attempt was unsuccessful, the substance caused irritation of the peritoneum and uterus. A year later, Lugol's solution was replaced with bismuth paste, and then with other drugs. They did not bring the desired result, in addition, they all provoked inflammation of the peritoneum.

It was possible to bring the HSG to a new level only in 1925, when lipiodol (a substance containing iodine) was first used during the procedure. This preparation made it possible to visualize the state of the uterus and oviducts well, and also did not harm the patient's health.

results

If there are no adhesions in the female organs, then the uterus filled with fluid, the oviduct canals and the contrast flowing into the abdominal cavity will be clearly visible on x-rays. The conclusion of this HSG is the patency of the fallopian tubes. If fluid retention is observed in some area, a diagnosis of "obstruction" is made. Also, according to the results of hysterosalpingography, the presence of the following diseases can be diagnosed:

• fibroids;
• polyps in the uterus;
• hydrosalpinx.

Even with a successful examination, the risk of inaccurate results remains. In some cases, an additional diagnostic procedure, hysteroscopy, may be prescribed.

Indications

HSG of the fallopian tubes is performed in the presence of strong indications. The procedure is prescribed by a gynecologist after examining the patient and in the absence of other methods for examining the uterus and the patency of the oviducts.

Hysterosalpingography is indicated for the following diseases and pathologies:

• infertility of unknown origin or caused by hormonal imbalance;
• suspicion of poor patency of the fallopian tubes, which leads to an ectopic pregnancy or causes problems with fertilization;
• the presence of sores and inflammation in the uterine cavity (fibroids, endometriosis, etc.);
• suspicion of tuberculosis of female internal organs;
• complications after miscarriage or abortion;
• hypoplasia of the uterus (developmental delay) or anomalies in the structure of the fallopian tubes;
• suspicion of adhesions in the uterus or oviducts;
• preparation for artificial insemination and in vitro fertilization.

Preparation for the procedure

Patients who are assigned this procedure for the first time are interested in the preparation of the fallopian tubes for HSG. There are several recommendations here:

1. Carefully protect yourself from conception, starting from the first day of the cycle in which the diagnosis is assigned. X-rays and components of the contrast agent can adversely affect the development of the embryo. It is also possible that the fertilized and moving egg cell will simply be washed away by the injected substance into the abdominal cavity. This point cannot be neglected, since very often a pregnancy that occurred shortly before the HSG or immediately after it has to be interrupted even for long periods.
2. During the 7 days preceding the procedure, douching and vaginal suppositories should not be inserted into the vagina without instructions from the attending physician.
3. Since the diagnostic procedure is performed without anesthesia, it makes sense to discuss the issue of anesthesia with a specialist. If it is not provided, then you can independently take an antispasmodic or analgesic 30 minutes before the HSG (for example, "No-shpu" or "Baralgin"). This will be especially useful for women with a low pain threshold.
4. Before the HSG, take a sedative to relieve muscle spasms, as well as get rid of nervousness.
5. Two days before the proposed procedure, you should give up sexual activity.
6. For three days before the procedure, it is not recommended to eat foods that cause gas formation in the intestines.

Before conducting HSG of the fallopian tubes, it is necessary to take blood, urine and smear tests for flora. If the results show an inflammatory process in the genital tract, the procedure will have to be postponed, otherwise the infection will go up into the uterus and fallopian tubes.

For the procedure, you should take a change of clothes, pads, a diaper, shoes or shoe covers. In any case, you should first consult with your doctor, since each medical institution has its own rules in this regard. On the day of the examination, a cleansing enema is given, the bladder is emptied, and pubic hair is removed.

On what day do the HSG of the fallopian tubes?

The exact timing for the study depends on the purpose of the diagnosis. If it is required to confirm the presence of endometriosis, then HSG is prescribed on the 7-8th day of the cycle. To assess the patency of the oviducts, the procedure is carried out in the second phase of the cycle. If uterine myoma is suspected, hysterosalpingography is prescribed in any phase of the cycle.

The most optimal for the HSG are the first 14 days after menstruation. At this time, the endometrium is still very thin, and therefore is able to provide free access to the mouths of the fallopian tubes.

Contraindications

HSG is contraindicated:

• with general infectious processes occurring in the body (flu, rhinitis, tonsillitis, furunculosis, thrombophlebitis, etc.);
• hyperthyroidism;
• severe diseases of the kidneys and (or) liver;
• insufficiency of the cardiovascular system;
• acute inflammation in the uterus, ovaries and oviducts;
• infectious inflammation of a large gland in the vestibule of the vagina;
• cervicitis (inflammation of the cervix);
• poor blood and/or urine tests.

Absolute contraindications are pregnancy and hypersensitivity to iodine.

Does HSG promote conception

Hysterosalpingography is primarily an informative research method that is prescribed to determine the causes of female infertility. After HSG of the fallopian tubes, pregnancy does not occur, since this method is only a therapeutic measure. However, the procedure allows you to assess the condition of the oviducts and correct the subsequent actions of the gynecologist, reproductologist and expectant mother for the desired pregnancy to occur.

Adverse reactions

With hysterosalpingography, side effects are possible due to the fact that a dye is used during the diagnosis. Consequences of HSG of the fallopian tubes:

• cramping pains;
• increase in body temperature;
• secretion of a bloody vaginal secretion in a small volume;
• nausea;
• delay in menstruation.

After the study, it is desirable to exclude physical activity. If the discomfort persists for more than 1-2 days, it is necessary to inform the doctor about them.

Is there a risk from radiation?

For the HSG procedure, X-rays are used. However, the average dose of radiation that the patient receives during the examination is much less than that which can cause mutations and tissue damage. Therefore, the radiation received during the HSG cannot harm either the expectant mother or her children.

Recovery period

During the first days after HSG of the fallopian tubes, it is possible to secrete scanty bloody or mucous vaginal secretions. Also, the patient may be disturbed by minor pain between the legs or in the lower abdomen. In most cases, these symptoms disappear quickly and do not require special treatment. With severe discomfort, it is allowed to drink painkillers.

Within 2-3 days after hysterosalpingography, you can not:

• use gynecological tampons (it is allowed to use sanitary pads);
• douching;
• lie in the bathroom, go to the bath or sauna (it is allowed to wash in the shower).

It is one of the most informative in the diagnosis of diseases of the pelvic organs. HSG, or hysterosalpingography, is another additional imaging method that allows you to get a more complete picture of the anatomical and functional state of the uterine cavity and fallopian tubes. It is especially widely used to diagnose the causes of infertility.

Preparation for hysterosalpingography

Deadlines for the procedure depend on the presumptive diagnosis and the purpose of the study. To assess the patency of the fallopian tubes, as well as to clarify the presence or absence of internal endometriosis and adenomyosis, HSG is performed on the 5-8th day of the menstrual cycle, if cervical insufficiency is suspected, in its second phase (on the 18-20th day). Diagnosis of the volume and boundaries of the submucosal (under the mucous membrane) of the myomatous node is carried out on any day of the menstrual cycle, provided there is no abundant bleeding from the genital tract.

Indications and contraindications

indication to hysterosalpingography is the assumption of the presence of:

1. Isthmic-cervical insufficiency - expansion of the cervical canal and its internal pharynx up to 5-7 mm.
2. Anomalies in the development of the uterus and appendages.
3. Submucosal fibroids or synechia (adhesions in the uterine cavity).
4. Adenomyosis, endometrioid cancer, polyps, genital tuberculosis.

One of the stages of preparation is the examination of the patient by a gynecologist and preliminary studies in order to determine not only indications, but also contraindications for HSG.

Contraindications:

1. Assumption of the possibility of pregnancy.
2. Pregnancy and lactation.
3. Bloody discharge from the genital tract.
4. Acute infectious diseases.
5. The degree of purity of the vagina is below II degree and acute inflammatory processes of the genital organs or urinary tract - bartholinitis, vaginitis, cervicitis, salpingo-oophoritis, urethritis, cystitis, pyelonephritis.
6. Severe chronic somatic diseases.

• stopping the use of vaginal remedies and douches 7 days before the study, if they are not prescribed by a doctor, and within 3 days after the procedure;
• refusal of sexual intercourse or the use of contraception during the menstrual cycle during which the examination is planned;
• lack of sexual contact within 1-2 days before the procedure and 2-3 days after the study;
• exclusion from the diet of foods that promote gas formation in the intestines, 3-4 days before the study, cleansing enemas the night before and in the morning on the day of the procedure.

Hysterosalpingography is normal

How the study is done

The method exists in the form of two options, depending on the equipment used - radiopaque (Rg-HSG) and sonographic, or ultrasound (Uz-HSG). With any option, hysterosalpingography is performed on an empty stomach without the use of anesthesia.

The procedure can cause the examined patient to feel discomfort, discomfort in the lower abdomen and slight pain. Therefore, with psycho-emotional instability and high excitability, fear about the procedure, and at the request of a woman, it is possible to administer sedatives or conduct adequate general intravenous anesthesia.

The study is carried out on a gynecological chair. After a preliminary examination and anesthesia (if necessary), a special balloon catheter about 35 cm long and with a lumen diameter of 0.2 cm is inserted into the cervical canal.

Through the outer end of the cannula, 2.5-3 ml of an X-ray or echo-contrast solution is injected into the cervical canal with a syringe, and an X-ray image or examination on the screen (in the case of US-HSG) of the inner surface of the uterine cavity is performed. Then about 4 ml of contrast solution is injected, which achieves a tight filling of the uterine cavity and the solution exits through the fallopian tubes into the pelvic cavity (to check the patency of the tubes). This is also fixed by a snapshot or inspection. If necessary, control is carried out by repeated introduction of another 3-4 ml of the solution. The total amount of the latter is 10-20 ml.

In order to diagnose isthmic-cervical insufficiency and find out its cause, a adrenal-progesterone test . During the HSG on the 18th day of the menstrual cycle, the sharply narrowed cervical canal and its internal pharynx are normally determined. If they are expanded, the named test is carried out.

It helps to establish whether the disorders are organic or functional. The essence of the test is the subcutaneous injection of 0.5 ml of adrenaline 0.1%. 5 minutes later, a control HSG is performed. If the narrowing of the cervical canal has not occurred, then in the evening of the same day, oxyprogesterone capronate (0.125 g) is injected into the muscle, followed by a repetition of the previous procedure after 4 days.

With functional cervical insufficiency due to insufficiency of the corpus luteum, after its correction with oxyprogesterone, a sharp narrowing of the canal occurs, but in the case of an organic cause of its expansion, it remains the same.

Thus, ultrasound hysterosalpingography and X-ray HSG are almost the same in terms of technical performance. In terms of information content, they are also equivalent. The main difference between the methods is:

1. used contrast solutions. In the case of US-HSG, an echocontrast solution is used that does not cause allergic reactions - a 10% glucose solution or echovist, which is a galactose granulate in a vial. It is dissolved immediately before the study to a 20% suspension with a solvent attached to the preparation. For X-ray HSG, iodine-containing radiopaque preparations are used - Verographin, Triombrast, Urotrast or Cardiotrast. Their introduction should be preceded by a sensitivity test, since any of these drugs can cause a severe allergic reaction.
2. Degrees of influence of physical factors (radiation). Uz-HSG is based on the use of the effect of ultrasonic waves, which do not have a negative effect on the genitals. Despite the fact that a small dosage of X-ray radiation is used for Rg-HSG, nevertheless, with repeated shots, it has a summing biological effect on the ovaries. Therefore, an attempt to become pregnant is recommended only after the menstruation following the study.

The consequences of hysterosalpingography

In some women who have undergone HSG, the onset of the first menstruation after the procedure occurs later than usual, with the subsequent restoration of the previous cycle. Such a delay after hysterosalpingography, usually not exceeding a few days, is apparently associated with psycho-emotional stress and mechanical interference in the function of the genital organs.

HSG is purely diagnostic and not therapeutic. However, many patients who have been examined for infertility note the onset of pregnancy in the next 3 months after the study.

There is no scientific explanation for this. Some doctors associate pregnancy after hysterosalpingography with the introduction of an oily solution of a radiopaque substance, which supposedly improves the function of the villous epithelium of the mucous membrane of the tubes and destroys "loose adhesions", which is unlikely.

More convincing is the assumption of mechanical washing away with a solution of a contrast agent of mucus formed on the mucous membrane of the walls of the fallopian tubes in the presence of a sluggish inflammatory process that was not previously diagnosed. As a result, the patency of the tubes and the function of the villous epithelium are restored for some time.

Another suggestion is a short-term correction of the function of the corpus luteum with oxyprogesterone during the adrenal-progesterone test.

After the HSG, unpleasant sensations in the lower abdomen may persist for 1-2 days, slight bloody and / or mucous discharge may appear. If the procedure was performed against the background of a chronic inflammatory process, an exacerbation of the disease is possible.

At the same time, hysterosalpingography in most cases does not cause any serious consequences and is a highly informative additional method in the diagnosis of a number of diseases and causes of infertility in women.

There are many reasons why some women do not get pregnant for a long time. One of them is the obstruction of the fallopian tubes. To identify such a pathology, special studies are prescribed. Learn how to check the patency of the fallopian tubes. Understand this diagnostic procedure, preparation, and implications.

What is hysterosalpingography

This difficult to pronounce concept means a special medical procedure or x-ray. It is carried out to check the condition of the uterus and fallopian tubes, as well as assess their patency. Indications for hysterosalpingography are cases when women cannot conceive a child for a long time or they have already had several miscarriages.

Checking the patency of the fallopian tubes

There are 3 methods by which the patency of the fallopian tubes is checked. The main one is hysterosalpingography. The procedure is an x-ray of the fallopian tubes. First, a rubber tip is inserted into the cervix, and a thin tube called a cannula is inserted through it. Through the latter, a dye enters, more often blue. Then a picture is taken with the help of x-rays. It displays the structure of the uterine cavity and the tubes extending from it. Other methods of studying these organs include:

echohysterosalpingography

Assessment of the state of the fallopian tubes and uterus by ultrasound is carried out on the monitor, and not on the picture, as with HSG. Its advantage is the absence of radiation exposure. In addition, echography is also carried out without hospitalization of the patient. The recommended time for the procedure is the day before ovulation. Plus valuable period - the cervix is ​​relaxed. As a preparation for an ultrasound scan, a woman only needs to not eat for 2-3 hours before the procedure. With increased gas formation, the gynecologist may prescribe Espumizan, which they drink 2 days before the study.

To conduct ultrasound, a woman must pass the following tests: for hepatitis, HIV, syphilis and vaginal microflora. This is necessary to exclude the presence of viruses in the body. During the procedure, patency is indicated by the fact that the contrast agent freely passes through the fallopian tubes and enters the abdominal cavity. According to the reviews of women, it can be concluded that after the ECHO-HSG, there are slight pains that disappear during the day.

X-ray on the patency of the fallopian tubes

X-rays or HSG examine the fallopian tubes only in non-pregnant women, because radiation is harmful to the embryo. In such cases, the previous method is used, i.e. echography. X-ray is more informative, it is easier to assess the condition of the abdominal organs. The procedure has some disadvantages. Among them are noted:

1. radiation, albeit in a small dose;
2. possible allergic reactions to the contrast agent;
3. mechanical damage to the epithelium, followed by bleeding.

Price of hysterosalpingography

As for the cost of HSG of the fallopian tubes, it depends on the chosen method. In a public clinic, any such procedure will be free. In private institutions, the price for X-rays varies from 1500 to 5000 rubles, and for ECHO-HSG - from 5000 to 8000 rubles. There is variation due to the variety of procedures. The top bar also includes other services:

• consultation with a gynecologist;
• examination under anesthesia;
• the presence of the husband at the event.

How to check the patency of pipes

With any method of studying the patency of the fallopian tubes, everything begins with an examination by a gynecologist and an appointment for them to pass the necessary tests. In addition, the doctor must choose the time when it is better for the patient to undergo the procedure. To avoid inaccurate results, the specialist must be sure that on the day of the study, the woman's uterus will be in a relaxed state, then the risk of spasms is much less. After passing the mandatory tests and proper preparation, the procedure itself is carried out to establish the patency of the fallopian tubes.

What tests are needed for the HSG

The first in the list of necessary tests are general studies of urine, blood and its biochemistry. Tests for syphilis, HIV, hepatitis are mandatory. You also need to take a smear from the vagina to study its microflora. When prescribing an x-ray of the fallopian tubes, be sure to do a pregnancy test or take a blood test for hCG. This study is the difference between the process of preparing for HSG and ECHO-HSG, because the latter can be used for pregnant women.

Preparation for HSG pipes

This procedure requires the woman to behave in a special way in the days leading up to the date of the examination. The latter falls exclusively on the 5-9th day of the menstrual cycle. The very preparation for the HSG of the fallopian tubes includes the following rules:

1. 1-2 days before the HSG, you need to stop having sexual intercourse.
2. During the week before the examination, douching procedures and the use of special personal hygiene products are not recommended, i.e. tampons.
3. It is also necessary to stop the use of vaginal suppositories, sprays or tablets a week before the examination in the absence of their agreement with the doctor.
4. On the day of the examination, it is better to remove excess hair on the external genitalia.
5. Before the HSG, be sure to empty the bladder and intestines. If there was no stool, then a cleansing enema should be performed.

Effects

Even the safety of the HSG procedure does not guarantee the absence of its negative consequences. The first on the list is an allergic reaction to the contrast composition. This phenomenon is typical for women who have previously had such “responses” in other examinations. Allergies can also occur in patients suffering from bronchial asthma. Even more rarely, bleeding, infection, or perforation of the uterus are noted.

X-ray radiation does not pose any danger to a woman at all, because its dose in the amount of 0.4-5.5 mGy is much lower than that which could lead to tissue damage. In most cases, pain and small bleeding will go away on their own after a few days. The main thing is to limit yourself from tampons, douching, baths, saunas or baths. If the blood does not pass within a couple of days, while still accompanied by an unpleasant odor, then consult your doctor.

Pregnancy after tube check

Doctors do not have an exact scientific rationale for why pregnancy develops after HSG. Statistics also note that this procedure really increases the percentage of a woman's ability to conceive a child. Especially often this happens when the analysis for the patency of the fallopian tubes is carried out using oily contrast agents. For this reason, some delay in menstruation after the HSG may indicate not only the stress experienced by the woman, but also a possible pregnancy, which you should definitely make sure of.

Visualization of the uterine cavity and appendages allows doctors to determine the state of the female reproductive system. HSG of the fallopian tubes (hysterosalpingography) is a diagnostic procedure. It is considered the most informative in identifying pathological changes in the pelvic organs. The method has become widespread for diagnosing the causes of infertility. What are its features, what varieties of it exist, we will tell in our article.

What is hysterosalpingography

HSG plays an important role in gynecology. With the help of this diagnosis, the patency of the fallopian tubes is determined. This pathology is a common cause of infertility: in the presence of tubal adhesions, a woman will never be able to become pregnant naturally.

Fallopian tubes - "highways" in which the egg meets the sperm, and then, fertilized, enters the uterine cavity. She is unable to move on her own. Therefore, its smallest “hairs” that cover the inner surface of the pipes are promoted. Having reached the uterus, the zygote is introduced into its walls, in order to then develop there until the very birth.

Therefore, checking for patency of the pipes is an important diagnostic step. After all, numerous adhesions will not allow fertilization to occur. And if it happens, then the egg will not be able to get to the “final destination”.

Is it possible to get pregnant if the tubal obstruction is partial? Yes, but such a pregnancy can be dangerous. The egg, fertilized by the sperm, will begin its movement through the tube. However, having encountered an obstacle along the way, it will begin to be imported into the tube itself: an ectopic pregnancy will occur. If pathology is not detected in time, a gap will occur after 4-6 weeks from the start of implementation.

The essence of hysterosalpingography is to fill the uterine cavity and its tubes with a special substance, which is called a contrast agent. It is introduced using a catheter through the vagina. The study is carried out in two ways: using ultrasound and x-rays. The injected substance helps to identify inflammatory processes, neoplasms. If it circulates freely through the tubes into the abdominal cavity, then the woman does not need treatment.

Modern gynecologists prefer diagnostics using ultrasound. After all, it is also a method of treatment. The fact is that during the procedure, saline is immediately injected into the uterine cavity. It breaks small adhesions on its way into the tubes, removing all obstacles to conception. Therefore, many women after the diagnosis are able to become pregnant.

Indications and contraindications

HSG of the fallopian tubes helps to diagnose infertility, because it determines the appearance and functioning of organs important for pregnancy: the uterus and tubes.

The indication for the study will be suspicions of the development of such pathologies:

• Spike in pipes;
• abnormal shape of the uterus;
• Isthmic-cervical insufficiency;
• Fibroids or polyps in the uterine cavity;
• Adenomyosis.

Diagnostic research is also carried out before the start of ovulation stimulation.

• pregnant women;
• with diagnosed inflammatory or infectious processes of the vagina or uterus;
• with uterine bleeding.

Like any study, hysterosalpingography has its advantages and disadvantages. We list the pros and cons of the GHA:

• clear visualization of the reproductive organs;
• the ability to eliminate small adhesions in the diagnostic process;
• minor exposure;
• the possibility of developing an allergy to a contrast agent;
• the risk of mechanical injury to the upper uterine layer.

Many women are interested in which procedure is better: HSG or laparoscopy. It should be remembered that laparoscopy is an surgical intervention that is performed under general anesthesia. Therefore, it is better to use HSG as a diagnostic method.

Where to do HSG

Hysterosalpingography (HSG) is carried out in public medical institutions under the MHI policy. You can also use the services of commercial centers. When choosing a hospital, pay attention to the quality of the equipment and the qualifications of the medical staff.

Research price

The cost of hysterosalpingography of the fallopian tubes depends on the clinic you have chosen and the type of diagnostic technique. So, in the centers of Moscow, the price for the procedure varies from 5,000 to 20,000 rubles.

Training

Preparation for a hysterosalpingography of the fallopian tubes will take some time. Before diagnosis, you need to undergo an examination by a gynecologist. The doctor will take a smear on the flora to exclude inflammatory processes. If they are identified, the HSG is not carried out until they are completely eliminated. The preparatory period also includes laboratory studies of the woman's biological material: blood and urine.

In preparation for the HSG of the fallopian tubes, they include the choice of the day when the procedure will be performed. Depending on the goals of the diagnosis, the doctor will prescribe a different time. However, in any case, the study is carried out in the first half of the monthly cycle. At this time, the endometrium is quite thin, and the uterine neck is soft. Therefore, the introduction of a catheter will require a minimum of effort on the part of the doctor.

2-3 days before the diagnosis, the patient should completely exclude intimacy. It is also not recommended to use vaginal suppositories, sprays and other therapeutic and prophylactic agents introduced into the vagina.

How is tubal HSG done?

The HSG procedure is carried out by two methods: using X-rays or ultrasound. Regardless of the prescribed technique, the diagnosis is carried out on the selected day of the cycle without anesthesia. During the study, the woman is not in pain, but she may experience some discomfort or discomfort in the lower abdomen. If the patient has a strong fear of the procedure, the HSG can be performed under local anesthesia. It is possible to use analgesics in tablets.

The duration of the study is 30-40 minutes. After its completion, the patient is left in the ward to exclude the possibility of bleeding.

Ultrasound hysterosalpingography

Ultrasonic hysterosalpingography is performed in a gynecological chair or on a couch. A woman needs to sit comfortably in a chair with her legs wide apart. After a brief visual examination, the patient will have a speculum inserted into the vagina, which will allow access to the cervix. To prevent infection, the neck is treated with an antiseptic.

The second stage of HSG ultrasound is the installation of a soft catheter in the area of ​​the cervical canal. At its end there is a vaginal sensor, with the help of which the “picture” enters the monitor screen. ECHO HSG of the fallopian tubes is performed using saline. They fill the uterine cavity and fallopian tubes. The free "spreading" of the liquid determines the good patency of the pipes. If during ECHO hysterosalpingography saline is distributed unevenly, this indicates that there are obstacles in the form of adhesions.

x-ray

X-ray of the fallopian tubes is carried out according to the scheme of the previous technique. The patient lies on a gynecological chair with her legs wide apart. After treatment with an antiseptic, a contrast agent is directed into the uterine cavity using a catheter. At the moment when the fluid fills the uterus and tubes, a series of radiographs is taken, on which the results of the study are recorded. After the diagnosis is completed, the hysterosalpingography catheter is removed.

HSG x-rays are performed using a special substance that does not transmit x-rays. Such fluids are called contrast fluids. This contrast in substances is achieved for a set of iodine content. First, the uterus is filled with liquid, making the required number of shots. Then, to check the patency of the pipes, an additional amount of solution is injected. Under pressure, the dye flows into the pipes, and the pictures fix the possibility of their patency.

Research results

The results of the two methods will “tell” with certainty about the condition of the uterus and tubes. The interpretation of the pictures is simple: the patency of the fallopian tubes is diagnosed if the injected substance, freely circulating through the uterus and tubes, enters the peritoneal cavity.

The picture allows you to diagnose other problems with the female reproductive system:

• Adhesions and polyps in the uterine cavity;
• uterine fibroids;
• Hydrosalpingix.

How to behave after the procedure, sensations

Unpleasant or dangerous consequences and complications after the diagnostic procedure are very rare. They are mainly associated with individual sensitivity to the components of the contrast fluid. Recovery of the body after the intervention can take place with minor discomfort and discomfort. It is accompanied by pain in the lower abdomen and vaginal spotting in a small amount. You should not worry about their appearance: such adverse reactions are a consequence of medical intervention. They will go away on their own in 3-4 days.

Sometimes a doctor prescribes antibiotics after an HSG. This appointment is associated with a possible risk of developing an infectious lesion. However, it is impossible to “prescribe” such medicines to yourself, because sometimes they are not necessary. In connection with possible infection, there is also a restriction in intimate life after the procedure. Sex after HSG is possible only after 3-4 days.

Many patients note a delay after the HSG. This deviation is not directly related to the procedure. Its occurrence is associated with the psychological discomfort of a woman during the diagnosis. Already in the next menstrual cycle, in the absence of other violations, menstruation will “come” on time.

When to plan pregnancy after HSG

Numerous online testimonials talk about how quickly women got pregnant after the HSG. And although there are no specific statistics, doctors note that pregnancy after HSG occurs quite often. Doctors attribute this fact to the "cleansing" of the pipes from small obstacles during the diagnosis. HSG and pregnancy in the same cycle is a common situation. However, it is not safe if performed using X-rays. Conception, which occurs in the same cycle, will “take away” the radiation received by the woman. This will negatively affect the development of the fetus.

Doctors believe that it is possible to plan a pregnancy as early as next month.

If pregnancy occurred after HSG ECHO, then there are no restrictions on the time of conception. This procedure is absolutely safe for the unborn baby.