Hysterosalpingogram (HSG)
The fallopian tubes must be open for an egg to travel from the ovary to the uterus. The uterus must be “disease free” and shaped normally to accept and support a developing embryo.
The HSG involves injecting contrast media, using a small catheter inserted through the vagina, into the uterus and monitoring its flow via X-ray from the uterus through the tubes and into the abdominal cavity. The HSG is an outpatient procedure performed at the hospital radiology department.
If the tubes are blocked, the dye cannot pass and this is visible on x-ray. Uterine abnormalities such as polyps, fibroids, or congenital malformations are usually visible in the HSG. The hysteroscopy and sonohysterogram are used to further evaluate the uterus.
Sometimes forcing dye through the tubes will cause them to open or small obstructions might be removed. Consequently, some women have an increased chance of pregnancy in the months immediately following the HSG.
Hysteroscopy
The physician views the inside of the uterus in the hysteroscopy. The uterine cavity is filled with fluid, causing it to expand, and a small “telescope” is passed through the vagina into the uterus. The physician can identify polyps, fibroids, adhesions, and other structural abnormalities. Many conditions can be surgically treated hysteroscopically.
Sonohysterogram
The sonohysterogram uses vaginal probe ultrasound to evaluate the uterus after it has been filled, and expanded, with saline solution. Abnormalities such as polyps and fibroids can usually be identified. The procedure is performed at our office and involves only minor discomfort.