Hysterosalpingogram (HSG)

During an HSG, a radiologist or gynecologist inserts a catheter into the cervix and injects iodinated contrast dye while X-ray images are captured. The dye outlines the uterine cavity and should flow freely through both fallopian tubes and spill into the peritoneal cavity if they are open (patent).

An HSG can reveal uterine abnormalities (polyps, fibroids, septum, adhesions) and tubal blockages. It is typically performed on cycle days 7–10, before ovulation. The procedure takes about 15 minutes and causes moderate cramping. Some studies suggest the HSG itself has a mild therapeutic effect — possibly flushing debris from the tubes — and spontaneous pregnancy rates may be slightly higher in the months following a normal HSG.