Recurrent Pregnancy Loss > Testing > Hysterosalpingogram

Hysterosalpingogram
A hysterosalpingogram (HSG) is an X-ray procedure in which an iodine-based dye is injected through the cervix, into the uterus, and out through the fallopian tubes. This procedure is performed soon after a period ends but before ovulation occurs, usually between days seven and ten of the menstrual cycle. It is appropriate to give a two- or three-day course of antibiotics for this procedure since dye is being injected through the cervix and into the fallopian tubes. This reduces the risk of infection as a consequence of doing this procedure to less than one percent.

In the X-ray department, a speculum is placed in the vagina and a small instrument is attached to the cervix. Under fluoroscopy, which allows the physician to observe the procedure as it is being performed, dye is slowly injected and is observed as it first fills the uterine cavity, then proceeds into the fallopian tubes, and finally out the ends of the fallopian tubes into the abdominal cavity. X-rays are taken at key points during the procedure, and the entire procedure usually takes less than ten minutes. There may be some mild cramping after this procedure, but patients can usually return to work that same day without difficulty.

This is the best measn of evalutating the uterus for a congenital uterine anomaly, an abnormality of the uterus that has been present since birth, or for some other type of anatomic abnormality such as a fibroid. Uterine anomlaies are clearly documented to cause recurrent pregnancy loss. the most commonly encountered uterine anomaly is a uterine septum. When the uterus forms, it begins as two tubew on the side of the pelvis that then fuse in the middle of the pelvis to form the uterus. The tissue in middle of these must be resorbed to form one uterine cavity. sometimes, 2-3% of the time, this resorption is incomplete, leaving a uterine septum Because this tissue was supposed to have been resorbed, it has a very poor blood supply. Should a pregnancy implant on the septum, there is not enough of a blood supply to sustain it and early losses occur. Fortunately, uterine septums are easily corrected by doing a hysterocopy. During this minor outpatient surgical procedure, the hysteroscope is introduced through the cerivx and into the uterus. The tissue of the septum is easily seen and is simply incised with a small pair of scissors or other tehcnique. Recovery is rapid, and after allowing the uterus to heal for two months, conception can again be attempted.

© 2005 Jarrett Fertility Group