Hysterosalpingography (another name is metrosalpingography) is an examination method that allows you to see the internal contours of the uterus and fallopian tubes
There are two types of this procedure: X-ray or ultrasound. Classic hysterosalpingography is a radiological examination, i.e. a series of X-rays is taken for its conduct.
As already mentioned above, there are two types of Hysterosalpingography: with the help of ultrasound (another name is sonohysterography) and with the help of X-ray. When comparing these methods of examination, it is impossible to single out the best one, since each one is designed for a specific purpose.
Sonohysterography (GHS with ultrasound) is used mainly for examination of the uterine cavity. With the help of this examination, abnormalities of the development of the uterus, deformation of the uterine cavity and other possible causes of infertility can be detected. But an ultrasound examination cannot reliably determine whether the fallopian tubes are open.
Hysterosalpingography with X-ray is the main method of assessing the patency of the fallopian tubes. Most experts believe that the X-ray method is indispensable if you need to check the fallopian tubes.
Indications and contraindications for hysterosalpingography
Not every patient of the gynecological office is prescribed the considered diagnostic procedure. There are certain indications for this:
In which cases hysterosalpingography is prescribed
Hysterosalpingography is widely used in the diagnosis of infertility, as it allows you to determine the shape of the uterine cavity and find out whether the fallopian tubes are passable. This type of examination can be prescribed:
- If the fallopian tubes are suspected to be blocked (for example, as a result of adhesions in endometriosis, salpingitis and other diseases)
- If abnormalities of the structure of the uterus are suspected (bicornuate uterus, underdeveloped uterus, partitions in the uterus, etc.)
- If uterine fibroids or uterine polyps are suspected
- Before stimulation of ovulation (for example, with polycystic ovaries)
- If adenomyosis is suspected
Despite the fact that hysterosalpingography is a common procedure, there are contraindications for its performance:
- pregnancy or suspected pregnancy;
- inflammatory diseases of the vagina or uterus;
- pronounced uterine bleeding;
- kidney / liver / heart failure;
- bad urine tests;
- infectious diseases;
- problems in the work of the endocrine system;
- thrombophlebitis;
- high level of leukocytes in the blood;
Features of hysterosalpingography
How is patency of fallopian tubes checked? First, the patient must undergo a preparatory stage, which includes the following procedures/manipulations:
- full-fledged gynecological examination and collection of biomaterial (smear of the vagina, cervical canal and cervix) for laboratory research;
- blood sampling for confirmation / refutation of infectious diseases;
- a week before the scheduled diagnostic procedure, a woman should refuse to use tampons, insert pills / suppositories / ointments into the vagina;
- sexual contact should be stopped two days before a possible examination;
- do not douche before hysterosalpingography.
Preparation for hysterosalpingography
Ultrasound-hysterosalpingography can be prescribed on different days of the menstrual cycle. It depends on the intended diagnosis: to detect the patency of the fallopian tubes, isthmicocervical insufficiency - in the second phase of the cycle, if internal endometriosis is suspected - on the 7-8th day of the cycle, if submucosal myoma of the uterus is suspected - in any phase of the cycle.
X-ray examination is performed for a comprehensive examination to clarify the causes of infertility, in preparation for IVF and artificial intrauterine insemination. In addition, the procedure is prescribed for suspicion of abnormalities in the development of the uterus (violation of the anatomical structure, underdevelopment of the uterus), intrauterine contractions caused by the inflammatory process after miscarriage or abortion, preparation for cavity operations (to exclude adhesion processes). X-ray GHS is performed in the first half of the menstrual cycle, because at this time the endometrium (the inner layer of the lining of the uterus) is quite thin, which allows you to see the overall picture most accurately. The most effective time for prescribing the procedure is the interval between the first day when a woman has no discharge after menstruation and ovulation: day 6-12 (with a 28-day cycle).
How does hysterosalpingography work?
So, you will be asked to sit in a gynecological chair with your legs apart, as during a simple examination. The gynecologist will insert a gynecological mirror into the vagina, which will help him see the cervix. After treating the cervix with an antiseptic (so as not to introduce an infection into the uterus) and a local anesthetic (to reduce discomfort), the gynecologist will insert a special catheter into the cervical canal (through which a contrast agent will be injected into the uterus) and remove the mirror from the vagina. You will be asked to sit under the X-ray machine. After that, a contrast agent will be injected into the uterus through a catheter. During the introduction of the substance, a series of X-rays is taken. After the procedure, the catheter will be removed.
Many women are worried about this procedure, they wonder if it hurts to check the patency of the fallopian tubes. This procedure is painless, but may seem somewhat uncomfortable or unpleasant. Anesthesia is not required for hysterosalpingography. In order to reduce discomfort during the procedure, the gynecologist can apply a local anesthetic to the cervix.
Consequences of hysterosalpingography
What consequences and complications can occur after hysterosalpingography?
What feelings will there be after hysterosalpingography?
- Discharge: After hysterosalpingography, you may have a viscous dark brown discharge that looks like blood. These are remnants of the contrast material, and possibly pieces of the endometrium (inner lining of the uterus). Use a sanitary pad in case of discharge.
- Pains: Minor pains in the lower abdomen after hysterosalpingography are also possible. They are associated with contractions of the uterus, which can be "irritated" by the procedure. To eliminate pain, you can take a No-shpi tablet.
What complications are possible with hysterosalpingography?
Complications of hysterosalpingography are very rare if the procedure is performed correctly. There is a certain risk of the following complications:
- An infection that penetrates into the uterus from the vagina or cervix can lead to the development of inflammation of the uterine mucosa (acute or chronic endometritis).
- Allergy to contrast material. If you have an allergy to iodine or other substances, be sure to inform your gynecologist.
When you can plan a pregnancy after hysterosalpingography
Since during X-ray hysterosalpingography, a contrast agent is injected into the uterus, it is not recommended to plan a pregnancy in the same cycle. You will be able to start conceiving a child in the next menstrual cycle (after the end of the next period).
It is worth noting that pregnancy after HSH fallopian tubes occurs quite quickly - this is a confirmed fact. Therefore, if the patient is in the process of infertility treatment due to fallopian tube obstruction, then the considered procedure is sometimes a decisive moment in increasing the probability of conception. If we take into account how much it costs to do an echo-GHS of the fallopian tubes, then we can say with confidence that this procedure is the cheapest method of infertility treatment.
The recovery period after this diagnostic procedure is fast - within two days, a woman may experience bloody discharge from the vagina, mild pains in the lower abdomen may bother her. In order to avoid the progression of complications, a woman should refrain from visiting saunas, baths, and open/closed water bodies in the first 5-7 days after hysterosalpingography.
More details about where you can check the patency of the fallopian tubes and how to properly prepare for the procedure can be found on our website Dobrobut.com.
Related services:
Gynecological Check-up
Surgical operations
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