“Hysterosalpingogram” is a pretty complicated word, but the procedure it describes is actually super simple. It’s an X-ray that doctors can perform to make sure your fallopian tubes are wide open and ready to transport your egg to the uterus.

For some women who have difficulty getting pregnant, ovulation and the menstrual cycle are working just fine. In this case, the problem could actually be that your fallopian tubes are blocked. This is exactly what women who get their “tubes tied” want to happen. But if you’re trying to get pregnant, having blocked fallopian tubes—often from scarring due to a previous infection—can lead to frustration.

To perform an HSG, doctors do a simple pelvic exam and inject a liquid through your cervix. This liquid enters your uterus and fallopian tubes. If your fallopian tubes are open, it flows right through them and into your abdomen (don’t worry, the liquid is totally safe!). This liquid can be detected by X-ray, so your doctors can actually see its progress through your body, and therefore can tell whether your fallopian tubes are open for business. If the liquid doesn’t flow through your fallopian tubes, chances are the tubes are blocked.

An HSG should normally be a very simple, pain-free procedure. But if doctors aren’t careful and inject the liquid too fast, the opening between your uterus and fallopian tubes can spasm, blocking off your fallopian tubes, leading to a false diagnosis of blockages. This can also be super painful!

What the Test Involves

A contrast, or dye, is gently inserted into your uterus. Pictures are taken of your uterus as it is filling, and additional dye is then added to make the dye “spill” through your fallopian tubes and into your abdominal cavity. If the dye can move through your fallopian tubes, doctors will know they are clear for egg and sperm travel. If the dye does not move through these areas, the dye will pinpoint the area blocking the way. The dye can also show the outline of your uterus (to ensure it’s a healthy shape) and any roadblock inside your uterus (such as scar tissue or a polyp).

Your fallopian tubes are the only passageway for your egg to reach your partner’s sperm, so finding any roadblocks is key information!

Tips & Hints

Often this test is performed during the first half of your menstrual cycle—this is to ensure you are not pregnant, as x-rays can be harmful to pregnancy.

Your doctor may recommend you take pain reliever beforehand to alleviate discomfort during the exam. If no prescription or over-the-counter medicine is suggested to you and you’re concerned about pain, ask about it at least a day before so you have time to pick up the medicine and take it as prescribed before the test.

Additionally, while some people feel fine after the test, others don’t feel well. Make arrangements for someone to drive you home afterward to ease your mind.

The HSG test is one of a series of tests involved in the infertility workup evaluating a patient for treatment.