Hysterosalpingography at KIMS Cuddles, Electronic City, Bengaluru
For conception to occur naturally, sperm must be able to travel through the fallopian tubes to meet the egg, and a fertilised egg must be able to travel back down the tube into the uterus. When one or both tubes are blocked, this journey cannot happen, and no amount of otherwise normal fertility function will overcome it. Hysterosalpingography is the investigation that answers this question directly, providing visual confirmation of whether the fallopian tubes are open and whether the uterine cavity has a normal shape.
At KIMS Cuddles at KIMS Hospitals, Electronic City, HSG is performed as part of the standard fertility investigation pathway for women across Electronic City, Hosur Road, Sarjapur Road, and South Bengaluru. It provides information that is essential for directing appropriate fertility treatment and that cannot be obtained through any other non-invasive investigation.
What HSG Is
Hysterosalpingography is a fluoroscopic imaging procedure that uses an oil and water-soluble contrast dye injected through the cervix to outline the uterine cavity and fallopian tubes under X-ray imaging. As the dye fills the uterine cavity and passes through the tubes, its distribution is visualised on a screen in real time. Normal tubes allow free flow of dye from the uterus through the tube and into the peritoneal cavity. A blocked tube prevents this flow, producing a visible cut-off at the point of obstruction.
The procedure is performed in a radiology suite and takes approximately fifteen to twenty minutes. HSG done without any form of anaesthesia can sometimes cause tubal spasm, resulting in the false reporting of blocked tubes. Hence, the process needs to be done under anaesthesia.
What HSG Can Show
Tubal patency is the primary information provided by HSG. The procedure identifies whether each tube is open, where any blockage is located, and in some cases gives an indication of the cause, whether adhesions from previous infection, endometriosis, previous surgery, or another structural factor.
Uterine cavity shape is simultaneously assessed as the dye fills the cavity. Filling defects within the cavity may indicate fibroids, polyps, intrauterine adhesions, or a uterine septum, any of which can affect implantation and pregnancy outcomes.
Proximal versus distal tubal occlusion has different clinical implications and guides different management decisions. Proximal occlusion, at the site of tube-uterus junction, may occasionally be due to tubal spasm during the procedure rather than genuine obstruction and may need repeat assessment or selective salpingography to clarify. Distal occlusion, at the end of the tube near the ovary, is more likely to represent true damage, often from previous infection, and is associated with a worse prognosis for natural conception.
When HSG Is Performed
HSG is scheduled in the first half of the menstrual cycle, typically between days six and twelve, after menstrual bleeding has stopped but before ovulation. This timing ensures that the procedure is not performed in an early pregnancy and that the uterine lining is not too thick to allow clear visualisation of the cavity.
After the Procedure
Light spotting for a day or two following HSG is normal and expected as the dye and any residual cervical manipulation resolve. Cramping on the day of the procedure typically settles within a few hours. A short course of antibiotics is prescribed around the time of the procedure to reduce the small risk of introducing infection into the reproductive tract.
Some studies suggest that the passage of contrast dye through the tubes has a mild therapeutic effect, slightly increasing the probability of natural conception in the months immediately following an HSG where the tubes are found to be open. This effect is thought to be due to the flushing of the tubes by the dye rather than any pharmacological effect.
HSG Versus Laparoscopy for Tubal Assessment
HSG is a first-line investigation for tubal patency assessment because it is non-invasive, does not require general anaesthesia, and provides immediate visual information. It has good sensitivity for identifying proximal tubal occlusion and gives useful information about the uterine cavity simultaneously.
Laparoscopy allows for a more complete evaluation of the pelvis and is the gold standard for finding peritubal adhesions, endometriosis, and subtle pelvic disease not detectable by HSG. It is indicated when the HSG findings are inconclusive, when there is a high clinical suspicion of pelvic disease or when other fertility studies are being done laparoscopically at the same time.
What Abnormal Findings Mean for Treatment
When HSG reveals bilateral tubal occlusion, natural conception and IUI are not viable options, and IVF becomes the appropriate treatment pathway. When unilateral tubal occlusion is found, fertility is reduced but not eliminated, as conception through the open tube remains possible.
When hydrosalpinx is identified, the decision whether to treat it before IVF varies from patient to patient. Laparoscopic salpingectomy or salpingostomy removes this negative effect and improves IVF outcomes substantially.
Why Choose KIMS Cuddles at KIMS Hospitals, Electronic City
HSG requires both radiological expertise in performing and interpreting the images and clinical expertise in understanding the implications of the findings for the individual's fertility treatment. At KIMS Cuddles at KIMS Hospitals, Electronic City, HSG is performed and interpreted within the context of the full fertility evaluation, ensuring that findings directly inform the treatment plan without the delay of coordinating between separate providers.
Book an Appointment
You can book your HSG appointment online or by calling KIMS Cuddles at KIMS Hospitals, Electronic City. Our specialists will also advise you on timing in your cycle, and give you written instructions for preparation prior to the surgery.
