Injecting dye into the fallopian tubes to solve infertility problems: What are the steps and preparations involved?

Hysterosalpingography (HSG) injection is another method used to investigate the causes of infertility, as well as to check for abnormalities within the uterine cavity and fallopian tubes. Many people may not know what a Hysterosalpingography injection is, the steps involved in the procedure, whether it is dangerous, and who should not undergo this test.

Hysterosalpingography (HSG) is a special radiological test that involves injecting an iodine-based contrast medium through the cervix into the uterine cavity and both fallopian tubes, followed by an X-ray imaging.

The purpose of this test is to observe the general shape of the uterus and to investigate the causes of infertility or sterility, such as uterine polyps, blocked fallopian tubes, or abnormalities in the shape of the uterine cavity.

There are two types of contrast agents: water-soluble and oil-based. Several studies have compared pregnancy rates between the use of water-soluble and oil-based contrast agents in hysterosalpingography. The findings suggest that using oil-based contrast agents for the procedure helps stimulate pregnancy more effectively than water-soluble contrast agents.

The benefits and advantages of hysterosalpingography are as follows:

• It helps determine whether the shape of the uterine cavity is normal or abnormal, such as abnormalities in the uterus, uterine fibroids, or adhesions in the uterine cavity.

• It is used to check if the fallopian tubes are blocked, and if so, to identify where the blockage occurs, allowing for further evaluation and treatment options.

However, there are limitations for certain groups who cannot undergo hysterosalpingography, including:

• Pregnant individuals

• Those with a history of contrast agent allergies

• Individuals with infections in the pelvic area

Using oil-based contrast agents can increase the chances of pregnancy because:

• The oil-based contrast agent helps to flush out the uterine cavity and fallopian tubes, removing small obstructions, creating a more favorable environment for fertilization between sperm and egg.

• The oil-based contrast agent can reduce the number of immune system cells (macrophages), which are responsible for destroying sperm through the body’s defense mechanism (phagocytosis). By decreasing the number of these immune cells, the oil-based contrast agent improves the chances of pregnancy.

• The oil-based contrast agent can increase the number of cells that help prepare the body for pregnancy (Uterine Natural Killer cells).

For women who wish to undergo hysterosalpingography, the preparation steps are as follows:

• The ideal time for the procedure is 2-7 days after the end of menstruation, but before the ovulation period. It is important to ensure that there is no pregnancy. If there is any suspicion of pregnancy, a test should be done to confirm it beforehand.

• Refrain from sexual intercourse from the first day after menstruation ends until the day of the procedure.

• Avoid carrying any metal objects, as the procedure involves the use of X-rays.

• If you have a history of allergy to contrast agents, contrast media, or seafood, you should inform the doctor in advance.

The steps of hysterosalpingography are not as scary as they may seem. Generally, the procedure begins with:

• The doctor will ask about your medical history before proceeding to the next step.

• Hysterosalpingography is similar to an internal examination, where the woman lies on the examination table with her legs placed in stirrups. The doctor will insert a speculum into the vagina to better visualize the cervix.

• The doctor will clean the cervix area and then insert a small tube (cannula) through the cervix. The speculum will then be removed, and a contrast agent will be injected into the uterus through the small tube. This contrast agent will flow into the uterus and through both fallopian tubes, then into the abdominal cavity.

• An X-ray will be taken, and the patient may need to change positions during the procedure.

• After completing the hysterosalpingography, the doctor will remove the small tube.

• Once the procedure is finished, the doctor may prescribe pain relief medication and antibiotics to prevent infection as appropriate.

Does hysterosalpingography hurt? Hysterosalpingography typically doesn't cause significant pain, but you may experience some discomfort or a dull ache due to the pressure inside the uterus. It is recommended to take pain relievers one hour before the procedure.

Is hysterosalpingography dangerous? Hysterosalpingography is generally not dangerous, but there may be some side effects afterward, such as light bleeding, abdominal pain, or a very small risk of infection (though this is rare).

Hysterosalpingography is a test to check for abnormalities within the uterine cavity and fallopian tubes, such as uterine polyps, fallopian tube blockages, or abnormal shapes of the uterine cavity, which can be causes of infertility. The procedure is similar to an internal examination, and patients typically do not experience pain, though there may be slight discomfort or a feeling of pressure.

After the test, there may be light spotting, but it should resolve within 24 hours. However, if there is heavy bleeding or unusual-smelling discharge, it is important to see a doctor promptly, as this could indicate an infection. If you have any questions, you can ask for more information via Line@ : @beyondivf.