How it goes and what it shows
Through a soft cannula, 10-15 ml of warm contrast is injected into the uterine cavity under the control of images: first, the triangular uterine cavity is contoured (filling defects - polyps, nodes, synechiae; changes in shape - septum, bicornuity), then the contrast fills the tubes and, when they are patency, freely spreads throughout the abdominal cavity. An antispasmodic before the study excludes false “obstruction” due to spasm. During the research cycle it is necessary to protect yourself. Based on the results, the reproductologist plans treatment: natural conception, insemination, laparoscopy or IVF (for bilateral obstruction and hydrosalpinx).
Indications
- infertility - assessment of patency of the fallopian tubes and uterine cavity;
- before stimulation of ovulation and insemination, after ectopic pregnancy;
- suspicion of intrauterine synechiae, anomalies (septum, bicornuate uterus);
- control after tubal plastic surgery and hydropertubation.
HSG and fertility
HSG remains the standard for the primary assessment of tubes in infertility: images document the filling of each tube and the free outflow of contrast into the abdominal cavity (tubes are patent) or the expansion of the ampulla without outflow (hydrosalpinx), a “break” in the isthmic section, and at the same time the contours of the uterine cavity - synechiae, septum, submucosal nodes, filling defects. The therapeutic effect is also known: in cycles after HSG (especially with oil contrast), the frequency of conception increases slightly due to the “washing” of the tubes. If there is obstruction, the next step is laparoscopy with chromohydrotubation, which clarifies and immediately treats the cause.
