If you're having trouble getting pregnant, your doctor might recommend a hysterosalpingogram (HSG) test to learn more about what might be causing the problem. It may sound a little intimidating, but this common test can give your provider important information about your uterus and fallopian tubes — and sometimes even help clear the path to pregnancy.
Here's what the test is, what the procedure is like, and what your results may show.
What is a hysterosalpingogram (HSG) test?
A hysterosalpingogram (HSG) is a test that checks a woman's uterus and fallopian tubes for any blockages or scarring that could prevent conception.
These tubal blockages can come from having an infection— from surgery or pelvic inflammatory disease, for example. Or it may result from a condition like endometriosis, uterine fibroids, or Asherman's syndrome (when tissue forms inside the uterus and/or the cervix after surgery).
"They found some adhesions/scar tissue from a previous C-section," What to Expect Community member HannahsMom2017 reports about her HSG.
"If a blockage is suspected, it's usually most useful to consult with your OB/GYN and/or a fertility specialist to review possible surgical and fertility treatment options," says What to Expect Medical Review Board member Aaron K. Styer, M.D., founding partner and medical director of the Colorado Center for Reproductive Medicine (CCRM) Boston in Newton, Massachusetts.
Dr. Styer says that while some women have become pregnant soon after the test is performed, it's meant to be a diagnostic tool, not a fertility treatment. Still, for some women, the test itself may improve fertility by flushing out blockages in the fallopian tubes.
"I conceived my daughter the following week after my HSG," says What to Expect Community mom KristyAR.
When is the best time to do an HSG test?
It's best to get an HSG test after your period ends but before ovulation occurs (days one to 14 of your menstrual cycle), according to the American College of Obstetricians and Gynecologists (ACOG).
This timing is recommended because it's the part of your cycle when you're least likely to be pregnant.
How to prepare for an HSG test
The test is quick, but there are some things you can do to prepare:
- Ask about pain relief. HSG tests can cause uncomfortable cramping, so many women opt to take an over-the-counter pain reliever about an hour beforehand. Just get the green light from your health care provider first.
- Take antibiotics, if prescribed. Some doctors recommend a short course of antibiotics to lower the risk of infection.
- Line up a ride. While you'll probably be fine driving yourself home, you may feel crampy, tired, or just ready for some support.
What happens during an HSG test?
An HSG test is usually done in your doctor's office and takes less than half an hour. You'll be awake for the procedure. Here's what to expect:
- You'll lie on an exam table, with your feet up, just like during a Pap smear.
- Your practitioner will insert a speculum to open your vagina.
- Your practitioner will clean your cervix. They may also inject a numbing medicine (this can feel like a sharp pinch or tug).
- A thin tube (catheter) is placed through your cervix, and dye is gently inserted.
- As the dye flows through your uterus and fallopian tubes, an X-ray machine takes pictures.
- The catheter will be removed, and a radiologist will review the images.
You may feel some mild to moderate cramping or pressure during the dye injection. For some women, the flow of dye can clear a small blockage — which is one reason some moms report conceiving soon after.
The whole procedure usually takes less than 30 minutes, and you can try for pregnancy soon after. "You can try to conceive with timed intercourse or sperm (partner or donor) inseminations within 24 hours after the HSG has been completed," says Dr. Styer.
"It was certainly uncomfortable," says What to Expect Community member kmgt11913 about her HSG. "But it wasn't bad and was done in like ten minutes."
What to Expect Community mom gigueremsa, on the other hand, says "I won't lie — it was painful. But it resulted in my BFP (Big Fat Positive) that cycle!"
What to expect after an HSG test
Some women find that any cramping they experienced during the procedure eases up a few minutes after the test ends, while others have abdominal discomfort or pain for several hours.
It's also normal to have some blood-tinged discharge as the fluid used during the procedure flows out of your uterus. Stick with pads instead of tampons until your doctor gives the all-clear.
Sometimes HSG tests can cause women to feel nauseous, dizzy or faint for a few minutes after the procedure, according to the Cleveland Clinic. If that's the case, take your time and stay lying or sitting down until you feel more stable. If you think a glass of water would help, ask for one.
HSG tests are routine procedures, and they rarely cause complications. But let your doctor know if you have worsening pain, fever, chills, foul-smelling discharge, heavy bleeding, fainting, or vomiting in the days after your test, which could signal an infection or an allergic reaction to the dye.
An HSG test can feel daunting, but many women find it's a valuable step in their fertility journey. It gives your doctor a clearer picture of what's going on and may improve your chances of conceiving soon afterward.
Yes 
No 
