Overview
What is an HSG Test?
The HSG test (Hysterosalpingography) is a special type of X-ray procedure that creates a clear picture of the inside of your uterus and checks whether your fallopian tubes are open. Think of it as creating a detailed roadmap of your reproductive system — using a safe contrast dye to highlight the path, allowing our doctors to identify any blockages or structural issues that could be preventing pregnancy.
It is one of the most important and commonly performed diagnostic tests for women facing challenges with conception, and provides invaluable information that no other single test can deliver.
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Fallopian Tube Patency
Checks whether both fallopian tubes are open and clear for the egg and sperm to meet and travel
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Uterine Structure
Examines the shape and inner structure of the uterus for abnormalities that may prevent implantation
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Precise Diagnosis
Identifies the exact location and nature of any blockage or abnormality — guiding targeted treatment
Why It's Needed
Why is an HSG Test Required?
The HSG test is a cornerstone of infertility diagnosis. Our specialists recommend this procedure primarily to investigate two of the most critical factors in female fertility:
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Blocked Fallopian Tubes
Blocked tubes are one of the most common causes of female infertility — accounting for up to 25–30% of cases. The HSG is the best diagnostic tool to determine precisely whether the tubes are open, partially blocked, or completely blocked, and at which specific location.
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Uterine Abnormalities
The test allows examination of the internal shape and structure of the uterus — identifying conditions such as fibroids (submucous), polyps, adhesions (Asherman's syndrome), or congenital abnormalities like a septum or bicornuate uterus that may prevent embryo implantation.
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Unexplained Infertility Investigation
When all other tests appear normal but conception has not occurred, the HSG is a critical next step to rule out structural causes — sometimes revealing subtle blockages or abnormalities that other tests miss.
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Recurrent Pregnancy Loss
Repeated miscarriages can sometimes be caused by uterine abnormalities — the HSG helps identify these structural issues so they can be treated before the next pregnancy attempt.
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After Tubal Surgery or Treatment
The HSG confirms whether a previous tubal surgery was successful in restoring tubal patency, and verifies the effectiveness of treatment for a prior blockage.
Procedure
How the HSG Test is Performed
The HSG procedure is performed by a radiologist or fertility specialist in a radiology suite or clinic procedure room. Here is a step-by-step guide to exactly what happens:
1
Scheduling — Day 7 to 10 of Your Cycle
The HSG is ideally scheduled between Day 7 and Day 10 of your menstrual cycle (counting Day 1 as the first day of your period). This timing ensures you are not pregnant and that the uterine lining is thin enough to give the clearest images. You may be advised to take a pain reliever 30–60 minutes before the procedure.
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Positioning & Preparation
You will lie on an X-ray table, similar to a gynaecological examination. A speculum is gently inserted into the vagina — exactly as during a routine Pap smear — to visualise the cervix. The area is cleaned with an antiseptic solution.
3
Contrast Dye Injection
A thin, flexible catheter (tube) is gently passed through the cervix into the uterus. A special, safe water-soluble contrast dye is then slowly injected through the catheter. You may feel mild cramping at this stage — similar to period pain — as the dye flows in.
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X-Ray Imaging (Fluoroscopy)
As the contrast dye fills the uterus and fallopian tubes, a series of real-time X-ray images (fluoroscopy) are taken. If the tubes are open, the dye will spill freely into the abdominal cavity — clearly visible on the X-ray. Any blockage will appear as a point where the dye stops flowing.
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Completion & Report
The entire procedure takes just 20–30 minutes. The catheter and speculum are removed, and you can rest for a short while before leaving. Your X-ray images are reviewed immediately and a detailed report is prepared on the same day. Our fertility specialist will discuss the findings with you and map out the appropriate next steps.
Understanding Results
How to Read Your HSG Results
Your HSG report will describe what was seen in both the uterus and the fallopian tubes. Here is what common results mean:
| Finding | Result | What It Means | Next Step |
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| Both tubes open, dye spills freely | ✅ Normal | Fallopian tubes are clear and patent — no structural blockage | Investigate other fertility factors |
| Dye stops at one tube | 🔴 Unilateral Block | One tube is blocked — the other may still allow conception | Medical or surgical treatment |
| Dye stops at both tubes | 🔴 Bilateral Block | Both tubes are blocked — natural conception very unlikely | IVF strongly recommended |
| Tube filled with fluid (hydrosalpinx) | 🟠 Hydrosalpinx | Tube is blocked and fluid-filled — can reduce IVF success rates | Surgical removal before IVF |
| Irregular uterine cavity | 🔴 Uterine Anomaly | Fibroids, polyps, septum, or adhesions detected in uterus | Hysteroscopy for treatment |
| Uterine cavity normal shape | ✅ Normal Uterus | No structural abnormalities identified inside the uterus | Continue fertility evaluation |
Before Your Test
How to Prepare for the HSG Test
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Schedule on Day 7–10
Book the test after your period ends but before ovulation — typically between Day 7 and Day 10 of your cycle for the clearest images.
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Take a Pain Reliever
Take an over-the-counter pain reliever (like ibuprofen) 30–60 minutes before the procedure to minimise discomfort during dye injection.
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Inform About Allergies
Tell your doctor about any allergy to iodine, contrast dye, or shellfish — as the contrast used in HSG is iodine-based.
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Avoid Vaginal Products
Do not use tampons, vaginal creams, or douches for 24 hours before the procedure. A sanitary pad is fine to bring for after.
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Arrange Transportation
While most women drive home independently, mild cramping may occur — consider arranging for someone to accompany you for comfort.
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Bring Previous Reports
Carry any previous fertility investigation reports, cycle history, and the referring doctor's letter to your appointment.
Who Needs This Test
Who Should Get an HSG Test?
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Women Struggling to Conceive
If you have been trying to get pregnant for 6–12 months without success, the HSG is a standard and essential part of the fertility workup.
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Recurrent Pregnancy Loss
Two or more miscarriages may be caused by uterine structural problems — the HSG helps identify and then treat these issues.
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History of Pelvic Infections / STIs
Past pelvic inflammatory disease (PID) or sexually transmitted infections can cause tubal scarring — the HSG checks if damage has occurred.
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Prior Pelvic or Abdominal Surgery
Previous surgeries (appendix, ovarian cysts, caesarean) can cause adhesions — the HSG verifies whether these affect the tubes or uterus.
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Before Starting IVF / IUI
Many specialists recommend an HSG before any ART procedure to confirm the uterus is structurally normal for embryo transfer or insemination.
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After Tubal Surgery
The HSG confirms whether a tubal surgery (to treat a blockage or reverse a ligation) was successful before trying to conceive.
Safety & Side Effects
What to Expect After the HSG Test
Mild cramping similar to period pain during and immediately after the procedure is the most common experience — this usually resolves within 30–60 minutes of completing the test.
Light spotting for 1–2 days after the procedure is normal and expected as the uterine lining reacts to the contrast dye. Use a sanitary pad rather than a tampon.
A slight vaginal discharge of residual dye or fluid may occur for a day or two — this is completely normal and not a cause for concern.
Serious complications are rare when performed by experienced specialists. However, please contact us immediately if you experience: heavy bleeding, severe pain, fever, or foul-smelling discharge — as these may indicate an infection requiring prompt attention.
✨ Therapeutic benefit: Many women report improved natural conception rates in the 3–6 months following an HSG — the dye flushing through the tubes may clear minor mucus plugs and subtle blockages, creating a fertility-boosting effect.
Why Matrushri
Benefits of HSG Testing at Matrushri
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Specialist-Performed Procedure
Performed by experienced fertility specialists — not junior technicians — ensuring precision, minimal discomfort, and accurate interpretation of findings.
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Advanced Fluoroscopy Equipment
High-resolution digital fluoroscopy imaging gives our specialists the clearest, most detailed view of your reproductive anatomy for precise diagnosis.
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Same-Day Report & Consultation
Your HSG images are reviewed and reported on the same day — followed immediately by a specialist consultation to explain findings and plan next steps.
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Transparent, Affordable Cost
Full pricing transparency with no hidden charges — every rupee you invest goes toward accurate diagnosis and actionable fertility guidance.
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Compassionate, Gentle Care
We understand the HSG can feel daunting. Our team prioritises your comfort, explains every step before it happens, and supports you throughout.
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Two Convenient Locations
Available at both our Hyderabad (Kukatpally KPHB) and Tirupati (Laxmipuram Circle) branches — accessible across AP & Telangana.
FAQs
Frequently Asked Questions
Is the HSG test painful?
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Most women experience mild to moderate cramping during the HSG — similar to period pain — particularly when the contrast dye is injected. This usually lasts just a few minutes. Taking an over-the-counter pain reliever like ibuprofen 30–60 minutes before the procedure significantly reduces discomfort. Our specialists work gently and will talk you through every step to keep you as comfortable as possible. Most women find the procedure more manageable than they expected.
On which day of my cycle should the HSG be done?
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The HSG is ideally performed between Day 7 and Day 10 of your menstrual cycle, counting Day 1 as the first day of your period. This timing ensures: (1) your period has ended so the uterine lining is thin and the images are clearest, (2) you have not yet ovulated so there is no risk of disrupting an early pregnancy, and (3) the cervix is naturally slightly more open, making the procedure more comfortable.
Can I get pregnant after an HSG test?
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Yes — and interestingly, many women report improved chances of natural conception in the 3–6 months following an HSG. The contrast dye flowing through the fallopian tubes may flush out minor mucus plugs or debris, clearing mild blockages. Studies have shown slightly higher pregnancy rates in the months after an HSG for women with no major abnormalities. This is often referred to as the "therapeutic effect" of the HSG procedure.
Is the contrast dye in the HSG safe?
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Yes. The contrast dye used in the HSG is a water-soluble, iodine-based solution that is safe and approved for diagnostic use. It passes through the body and is excreted naturally. The radiation exposure from the HSG is minimal and well within safe limits. If you have a known allergy to iodine or contrast dye, please inform our team before booking — we will take appropriate precautions or consider alternative imaging options.
What if my HSG shows a blocked tube?
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Finding a blocked tube is not the end of your fertility journey. Depending on whether one or both tubes are affected, your specialist will discuss treatment options. If one tube is open, natural conception is often still possible. For both tubes blocked, IVF is the most effective treatment — bypassing the tubes entirely. Specific surgical treatments such as selective salpingography or laparoscopic tubal surgery may also be appropriate for certain types of blockages. Our team will guide you through every option with compassion.
How long does it take to get the HSG results?
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The HSG images are reviewed and a report is generated on the same day as your procedure. Because it is a real-time fluoroscopy procedure, the specialist can often discuss preliminary findings with you immediately after the procedure is complete. A full written report with images is then provided for your records, and a detailed consultation is scheduled to explain what the findings mean for your fertility treatment plan.