By Constance McGraw, MPH

What is the HSG test?

A hysterosalpingogram, or HSG test, is a minor X-ray procedure used to view the inside of the uterus and fallopian tubes and can also indicate if the uterus is of normal shape and size. It is often used as a routine part of an infertility workup to see if the fallopian tubes are partly or fully blocked.

HSG Test for Infertility 

HSGs are often a routine part of infertility workups. An HSG test uses X-rays and a special dye to find issues like scar tissue, polyps, fibroids, or growths that might block your tubes or stop a fertilized egg from implanting in your uterus. Blocked tubes or growths can make it harder to get pregnant. If your tubes are blocked, sperm can’t reach the egg. HSG may also be used following some tubal sterilization procedures to make sure that the fallopian tubes have been completely blocked or to examine reasons for recurring early pregnancy loss.

Benefits of HSG

The HSG test not only identifies blockages and growths but also has been suggested to improve fertility within 3-6 months through “tubal flushing.” Tubal flushing involves injecting dye into the uterus and fallopian tubes without an X-ray. Research indicates higher pregnancy and live birth rates when using an oil-based dye compared to water-based solutions. However, a Cochrane review on the efficacy of tubal flushing and fertility found that the studies identified were of poor quality and more robust research is needed to better understand comparing oil‐soluble versus water‐soluble media or no treatment on improving pregnancy rates post HSG test.