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Hysterosalpingography is an X-ray test used to view the insides of your uterus and fallopian tubes. The image produced is called a hysterosalpingogram. This procedure can help diagnose why you are unable to get pregnant. It is done in the X-ray center of a hospital or clinic.

During the procedure, a radiologist (doctor who specializes in the use of X-rays) takes images as a contrast dye flows through the uterus and fallopian tubes. The dye makes it easier to see these organs on X-rays. It can also help pinpoint the location of problems. In some cases, your health care provider will be present during the test. The test usually takes less than 30 minutes. You can often go back to your normal routine within a short time.

Woman lying on back on table under x-ray machine. Two healthcare providers are performing test. Image of inside of uterus is on monitor.

Reasons for the Procedure

Hysterosalpingography is used to diagnose problems with the fallopian tubes and uterus. These can include:

  • Blockage, narrowing, or distention of the fallopian tubes

  • Scarring of the fallopian tubes and uterus

  • Abnormalities in the shape and size of the fallopian tubes and uterus

  • Growths in the uterus

What Are the Risks?

Problems with the procedure are rare, but can include:

  • Infection

  • Bleeding

  • Allergic reaction to the dye

  • Damage to the uterus or fallopian tubes (very rare)

Getting Ready for the Procedure

The procedure will be scheduled shortly after the end of your menstrual period. When you schedule your test, tell your health care provider if you have allergies to iodine or shellfish. You will be asked to sign a consent form, and may want to arrange for a ride home after the procedure. In some cases, you’ll be given antibiotics to take before and after the test. A day or two before the exam, your health care provider may ask you to:  

  • Avoid sexual intercourse

  • Stop using creams or other vaginal medications

  • Avoid douching

  • Take over-the-counter pain medications a few hours before the test

During the Procedure

  • You will be asked to lie on an X-ray table with your knees bent and apart—much like the position when you have a pelvic exam.

  • An instrument called a speculum is inserted into the vagina to hold it open.

  • The cervix may be numbed and/or grasped with an instrument to keep it in position. Then a catheter (thin tube) is guided through the cervix and into the uterus. In some cases, the cervix is first dilated to widen the cervical opening. This process may cause some discomfort.

  • The radiologist will position the X-ray machine over your abdomen. Then contrast dye is injected through the catheter.

  • The dye may stretch the uterus and tubes, causing some cramping or pain.

  • As the dye flows through the uterus and tubes, X-rays are taken and displayed on a monitor. You may be able to watch the progress of the dye on the monitor. You may also be asked to change positions.

  • It is normal for some dye to spill out of the tubes and be absorbed by the body. The rest may appear later as vaginal discharge.

After the Procedure

  • If you feel lightheaded or dizzy, inform your health care provider. You can rest on the table until you’re ready to get dressed.

  • You might have a thick discharge as some of the dye drains out of the uterus. Use pads, not tampons, until the discharge is gone.

  • For a few hours you may feel some cramping. This can usually be relieved with over-the-counter pain medications such as Motrin.

  • You may be told not to have sexual intercourse or douche for a day or two.


After the radiologist has studied the X-rays, your health care provider will talk with you about the results of your hysterosalpingogram. This may be later the same day or during a follow-up appointment. In some cases, additional tests may be needed to look more closely at your reproductive organs. Your health care provider may also recommend medications or surgery to help correct a problem.

Call your health care provider if you have:

  • Severe or increasing pelvic pain

  • Heavy vaginal bleeding (more than a pad an hour for 2 hours)

  • Vomiting

  • A fever over 101°F

  • Foul-smelling or unusual vaginal discharge

Author: StayWell Custom Communications
Last Annual Review Date: 10/1/2014
Copyright © The StayWell Company, LLC. except where otherwise noted.
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