Hysterosalpingography (HSG Test)

HSG typically does not require anesthesia. Most patients describe mild to moderate lower abdominal cramping or discomfort — similar to period cramps — lasting only a few minutes. Taking an over-the-counter pain reliever (ibuprofen) 30-60 minutes before the procedure significantly reduces discomfort. Some light spotting or discharge after the test is normal and usually resolves within a few days.

Open fallopian tubes are one necessary condition for natural conception, but not the only one. A normal HSG result still requires evaluation of ovarian reserve (AMH, AFC), ovulation, uterine lining, and your partner's semen analysis to fully understand the cause of infertility. Some research also suggests a slight increase in natural conception rates in the months after HSG — possibly due to a mild flushing effect of the contrast dye — but this does not apply to every patient.

If HSG reveals one or both tubes are blocked, your physician will evaluate further and discuss treatment options: (1) One blocked tube: IUI or ovulation monitoring may still be attempted through the open tube; (2) Both tubes blocked: IVF is the most direct solution, since fertilization occurs outside the body and tubes are not needed; (3) Hydrosalpinx (fluid-filled tube): removal of the affected tube is typically recommended before IVF to prevent fluid from impairing embryo implantation.

HSG uses X-ray imaging, but the radiation dose is extremely low — far below everyday background radiation — and poses no meaningful health risk. The test is usually scheduled right after menstruation when pregnancy is least likely, further ensuring safety. Patients with iodine allergy should inform their physician in advance; an alternative such as ultrasound-based tubal evaluation (SHG/HyCoSy) may be used instead.