What is a Hysterosalpingogram (HSG)?

Trying to get pregnant can be an emotional rollercoaster. For some, it happens quickly. For others, it takes time, support, and sometimes, a bit of medical investigation. One of the most common diagnostic tools used in fertility assessments is the Hysterosalpingogram, or HSG.

This procedure helps doctors evaluate the uterus and fallopian tubes, checking if there are any blockages or abnormalities that might be affecting conception. In this article, we’ll break down exactly what an HSG is, how it’s done, what to expect during and after, and how soon you can start trying to conceive once it’s over.

Let’s get right into it.

What is an HSG?
A Hysterosalpingogram (HSG) is a specialized X-ray procedure used to examine the inside of the uterus and fallopian tubes. It’s part of many fertility workups and can provide crucial information about reproductive health.

During the procedure, a contrast dye is gently injected into the uterus through the cervix. This dye outlines the inner shape of the uterus and travels through the fallopian tubes. An X-ray captures the flow of the dye in real-time, showing whether the tubes are open or blocked and if the uterine cavity looks normal.

How is HSG performed?

Step-by-step process

1. Timing: The test is usually scheduled between days 6 and 12 of your menstrual cycle, after bleeding has stopped but before ovulation.
2. Positioning: You’ll lie on an exam table, similar to a pelvic exam or Pap smear.
3. Speculum Insertion: A speculum is inserted into the vagina to visualize the cervix.
4. Catheter Placement: A thin catheter is placed into the cervical canal, and the speculum is removed.
5. Dye Injection: Contrast dye is slowly injected through the catheter.
6. Imaging: A fluoroscopy machine takes continuous X-ray images to identify blockages or abnormalities.
7. Aftercare: The catheter is removed, and you’ll be briefly monitored before heading home.

How long does it take to do an HSG?

The actual HSG procedure takes about 5 to 10 minutes, though you should plan for a total visit of 30 to 60 minutes. Most patients describe the experience as uncomfortable but tolerable, with cramping similar to menstrual cramps when the dye is injected.

Are there side effects to HSG?

Common side effects:

• Cramping or pelvic discomfort during and after the procedure
• Spotting or light bleeding for 1–2 days
• Vaginal discharge (from the dye or fluid)

Less common side effects:

• Allergic reaction to the contrast dye (especially if it contains iodine)
• Infection, such as pelvic inflammatory disease (PID)
• Fainting or dizziness, especially in people prone to vasovagal reactions

Some clinics may prescribe antibiotics before or after the procedure to minimize the risk of infection. Contact your doctor immediately if you develop fever, foul-smelling discharge, severe pain, or heavy bleeding.

How soon after HSG can you start trying to conceive?

You can start trying to conceive immediately after your HSG, unless your doctor advises otherwise. Some studies even suggest that fertility may increase temporarily after the procedure, especially if the tubes were only slightly blocked or had mucus buildup.

If you’re cramping or uncomfortable, give yourself a day or two to rest, but don’t be surprised if your doctor gives you the green light right away.

Additional Considerations and Official Resources

An HSG is a powerful diagnostic tool, but it's just one piece of the fertility puzzle. Depending on your results, your provider might recommend additional testing like hormone panels, semen analysis, or a hysteroscopy.

An HSG tells you if the fallopian tubes are open and if the uterus is shaped normally, but it doesn’t show whether ovulation is occurring or whether the sperm is functional.

For more evidence-based guidance, visit these official resources:

• CDC
• National Institute of Child Health and Human Development
• Office on Women's Health
• MedlinePlus

Conclusion

An HSG might not be the most glamorous part of your fertility journey, but it can be one of the most illuminating. Whether you’re working with a fertility clinic, OB/GYN, or surrogacy agency, understanding your reproductive anatomy is a major step forward.

The procedure is quick, generally low-risk, and could even improve your chances of getting pregnant. If you’ve been trying for a while and haven’t gotten answers, an HSG may be the diagnostic nudge you need.

Talk to your doctor about whether an HSG is appropriate for you—and don’t forget to ask all your questions. Empowerment starts with information, and you’ve just taken a big step in the right direction.