Infertility Test - Hysterosalpingogram

Hysterosalpingography is one of those unwieldy medical terms that needs to be dissected before it can be properly understood. The suffix –ography is a term used in medicine to denote a test that results in an image, usually using X-ray radiation in some fashion. In hysterosalpingography, that is indeed the case, an X-ray or series of X-rays will be taken in order to better understand a patient’s anatomy. But what anatomy? That is where the rest of the word dissection come into play. Hystero- pertains to the uterus. A common example is a hysterectomy, a procedure in which the uterus is removed. Salpingo- is perhaps the most bizarre part of hysterosalpingography since it refers to the fallopian tubes, which are each known as a salpinx. Therfore a hysterosalpingography is an X-ray image of the fallopian tubes and uterus.

 

 

During a hysterosalpingography, a thin instrument is inserted into the vagina, across the cervix and into the uterus itself. Once inserted, a dye is infused which spreads out across the uterus and extends up into the fallopian tubes. This dye is not a color dye like you may use on clothes but rather it is an agent that shows up very well on an X-ray. Once the contrast dye has been given time to spread out, the hysterosalpingography is completed by taking a series of X-rays of the area.

 

The X-rays in a hysterosalpingography are delivered through a special X-ray system called a fluoroscope, which delivers a short constant stream of X-rays. A fluoroscope can produce a radiological film strip rather than the snap shot that is produced by a traditional X-ray device. The fluoroscope approach allows the physician performing the hysterosalpingography procedure to move the X-ray source in different directions and get a very detailed picture (or film) of the anatomy of the uterus and fallopian tubes.

 

The most common reason that a woman would need a hysterosalpingography would be if she is having trouble getting pregnant or carrying the fetus (repeated miscarriages). Two of the many possible causes of female infertility are a problem with one or both of the fallopian tubes or with the shape of the uterus itself. The fallopian tubes carry the egg from the ovary to the uterus. If the anatomy of the fallopian tubes is abnormal, the egg may not be able to make its way to the uterus.

Likewise, fertilized eggs may not be able to implant successfully in the lining of the uterus if there are many uterine fibroids or the lining of the uterus (endometrium) is abnormal. The hysterosalpingography procedure provides the doctor with a picture of the fallopian tube anatomy as well as a sense of what the interior of the uterus looks like.

 

You need to be reasonably healthy in order to have a hysterosalpingography procedure. If you have an infection of any kind, the test will be delayed. Also, if you have problems with blood clotting, this will need to be addressed prior to the hysterosalpingogram. There is also a narrow window of opportunity within the menstrual cycle that a hysterosalpingography can be performed. The hysterosalpingography procedure cannot be performed during active menstrual bleeding and is usually done three to five days after menses has stopped. The test cannot be done too close to ovulation (when an egg is released from the ovary) because the X-ray radiation could damage the developed fetus if the egg has been fertilized. This scheduling can become an important issue in women with irregular menstrual cycles but scheduling of hysterosalpingography is usually fairly flexible because of this.