When a woman decides that it is time to get pregnant, the gynecologist will send a sequence of tests for evaluation, which will determine the possibility of being able to get pregnant naturally or if some “extra help” is needed to facilitate it. When a certain difficulty is found, a specific exam, known as hysterosalpingography, may be indicated.
What is Hysterosalpingography?
Hysterosalpingography is an image exam, performed with the X-ray machine , but with the help of contrast for more detailed verification. Usually indicated to analyze the anatomy of the uterus and tubes, check for malformations and even possible scarring or the presence of something that prevents the development of an embryo , as well as if there is any impediment to a pregnancy happening.
Through the contrast injected during the examination, it is possible to analyze the trajectory of the liquid and if there is any impediment in the passage, including obstructions in the functioning of the fallopian tubes. It is one of the best tests to diagnose gynecological problems, linked to fertility.
IMPORTANT: The hysterosalpingography exam does not cause pain in the woman, but it can cause mild discomfort during and after the procedure.
How is Hysterosalpingography Performed?
The hysterosalpingography exam is usually performed at the gynecologist’s office. If the specialist does not have the device in the office, it may be indicated to perform it in a specialized clinic.
The procedure should be performed one week after menstruation and before ovulation occurs, to ensure that the woman is not pregnant. With the woman in a gynecological position, a catheter is inserted with a small “balloon” at the tip, which is inflated when it reaches the uterus, causing fixation of the probe.
After the probe is installed, iodine-based contrast injection is started. With the help of the x-ray image, the specialist will monitor the entire trajectory of the contrast and make the relevant notes, which will be given in the report.
It is common, during the hysterosalpingography exam, that the doctor asks the woman to change position , to facilitate the reading of the image and help to distribute the injected contrast.
In the past, thicker and metal probes were used, which makes the exam painful for women. With the modernization of medical instruments, the gauge of the probe was also adjusted, for a more flexible and thinner material , which allows the procedure to be carried out in a more comfortable way.
The exam does not cause pain, but it can cause some discomfort both during and after the exam. Therefore, the use of painkillers before starting to reduce these discomforts may be indicated.
The discomfort felt by the patient during the exam is similar to a mild menstrual cramping, which passes with the completion of the procedure. Usually, felt during the moment of injecting the contrast.
IMPORTANT: The exam has an average duration of 30 minutes.
After injecting the contrast, it will be necessary the right time for the liquid to spread through the reproductive system and be able to map its entire path. Soon after, the x-ray images are taken as a sequence, where the path taken by the liquid will be evaluated, and the existence of any anomaly will be verified.
Care for Performing the Hysterosalpingography Exam
Some recommendations are given and necessary for the hysterosalpingography exam. In addition to the exact period for the procedure mentioned above, which must be after menstruation and before ovulation, the use of a laxative the night before the exam is also indicated.
The use of the laxative is to ensure that gases or feces in the pelvic area do not interfere with the visualization at the time of the exam and do not provide an unsatisfactory result.
Before starting the hysterosalpingography exam, an analgesic should be ingested, if prescribed, to reduce discomfort during the exam and after the procedure as well.
The result of hysterosalpingography is provided through a report that accompanies the images taken during the procedure. Through these results, the gynecologist will analyze the uterine conditions and tubes and indicate the best treatment.
If in the report and images, the result informs that there is no irregularity in the reproductive system that causes infertility, other tests will be requested, including for investigation of male infertility.
Many couples spend months and even years performing tests on the woman to investigate her infertility, when in fact, the cause of the couple’s infertility is in the man. Therefore, it is essential that after ruling out problems in the female reproductive system, the man performs the tests for sperm evaluation.
A common alteration to be detected in the result of hysterosalpingography is that of tube obstruction. Which, by the way, can be resolved during the hysterosalpingography procedure.
Advantages of Hysterosalpingography
The test may be a little frightening to women, due to the method used, for injecting contrast and even for reports of discomfort during the exam. But still, it is the best method of analysis of the female reproductive system, since the contrast allows to accurately check the trajectory through the uterus and tubes.
Another important advantage is that the hysterosalpingography exam is quick and with little chance of complications, and that it can be controlled immediately and easily by the doctor performing the procedure. In addition, it has been proven that it increases the chances of the woman being able to get pregnant after the exam.
Hysterosalpingography With Sedation
For women who are afraid of the procedure and just listening to the reports think about giving up, there is the alternative of performing hysterosalpingography with sedation. However, it is not so easy to find clinics that do, even more reliable and that is recommended by your gynecologist.
Many experts believe that sedation is unnecessary to perform the procedure and that is why it is not so common. The discomfort caused during the exam is completely controlled and in some cases, women report not having felt any pain.
Hysterosalpingography Helps You Get Pregnant?
Due to several reports about women who managed to get pregnant naturally after the hysterosalpingography procedure, it was concluded that the method may, in some cases, assist in clearing the tubes or any other impediment, when it exists.
But we have to warn you, that is not the purpose of the exam. Its only function is to diagnose problems in the female reproductive system that may be causing infertility.
Recommended Treatments After Hysterosalpingography
Immediately after confirming the diagnosis, the gynecologist will indicate the best treatment, which fits your result. The treatments usually indicated are through medications, ovulatory induction, surgical intervention or even methods such as programmed coitus or assisted reproduction such as IVF in situations that cannot be solved more easily.
In case of an abnormality in the uterus, where the woman is unable to conceive, even undergoing any type of treatment or procedure, even if it is in vitro fertilization. The method known as a supportive belly can be indicated .
Currently, the method in Brazil is legalized, if the solidary belly is a relative up to the fourth degree of the couple. In this case, the father’s sperm and the mother’s eggs are fertilized in the laboratory and the embryo is implanted in the woman’s uterus that will make the belly solidary, so that it can generate it.
My name is Dr. Alexis Hart I am 38 years old, I am the mother of 3 beautiful children! Different ages, different phases 16 years, 12 years and 7 years. In love with motherhood since always, I found it difficult to make my dreams come true, and also some more after I was already a mother.
Since I imagined myself as a mother, in my thoughts everything seemed to be much easier and simpler than it really was, I expected to get pregnant as soon as I wished, but it wasn’t that simple. The first pregnancy was smooth, but my daughter’s birth was very troubled. Joana was born in 2002 with a weight of 2930kg and 45cm, from a very peaceful cesarean delivery but she had already been born with congenital pneumonia due to a broken bag not treated with antibiotics even before delivery.