What does an HSG test show before pregnancy?

What does the evidence say about hysterosalpingogram before pregnancy?

1. During HSG, contrast enters the uterus through a thin cervical catheter while X-ray images show the cavity and tubes. Cramping may occur. Ask about the clinic's pain-relief plan, infection precautions, and whether you need a companion if a sedating medicine is used. 1
2. A finding suggesting blockage close to both uterine openings may reflect temporary muscle contraction or catheter position. ASRM recommends further evaluation to clarify that pattern. A single image labeled blocked should be discussed with the clinician before concluding that both tubes are permanently closed. 2
3. HSG provides information about tubal passage and structure, but a tube that appears open is not a complete test of tubal function. Previous ectopic pregnancy, pelvic infection, endometriosis, and surgery help put the result in context. Ask what the report changes in the broader fertility plan. 3
4. A saline sonogram uses ultrasound rather than X-rays to examine the cavity, and specialized contrast ultrasound can assess tubal passage. These tests are related but not identical. Confirm which procedure was ordered and whether its main purpose is the cavity, the tubes, or both. 4
5. Tell the service about possible pregnancy, pelvic infection symptoms, and previous contrast reactions before the test. Afterward, fever, foul-smelling discharge, or significant pain warrants prompt contact. Follow the clinic's instructions rather than assuming all post-test discomfort is expected. 1

How can you prepare for an HSG and its results?

• Before booking, discuss the reason for imaging and pregnancy precautions.
• At the appointment, confirm the ordered test, comfort plan, and relevant medical history.
• After results, ask which findings are definite, which need clarification, and what happens next.

Questions for your fertility or prenatal team