Hysterosalpingography
Hysterosalpingography is a key diagnostic test in the evaluation of female fertility, as it allows assessment of fallopian tube patency and uterine morphology. The fallopian tubes play a crucial role in natural conception, since fertilization of the egg takes place there. When there is blockage or functional impairment, the chances of pregnancy are reduced.
This test is part of the basic infertility workup and often precedes the decision to proceed with in vitro fertilization, especially when conception has not been achieved after a reasonable period of trying.
In some cases, performing hysterosalpingography may also help improve tubal patency, which explains why a proportion of women achieve natural conception in the months following the examination.
How is it performed and where does it take place?
Conventional hysterosalpingography is performed at a radiology center. During the procedure, a special contrast medium is injected through the cervix and flows into the uterus and fallopian tubes. Using radiologic imaging, the path of the contrast is recorded to determine whether the tubes are open or whether there is a blockage.
The procedure usually lasts 15–30 minutes.
General anesthesia is not required.
In some cases, mild pain relief or an antispasmodic may be given for greater comfort.
The examination also allows:
- assessment of fallopian tube patency
- evaluation of the morphology of the uterine cavity
Alternatively, ultrasound hysterosalpingography (HyCoSy) can be performed in the gynecology office using ultrasound and a special foamy contrast medium, without radiation.
Your doctor will determine which type of examination is most appropriate, depending on your medical history and the stage of the evaluation.
When is hysterosalpingography performed?
Hysterosalpingography is usually performed between the 6th and 12th day of the menstrual cycle, that is, after the end of the period and before ovulation.
This specific timing is chosen for two main reasons. First, the endometrium is thin and allows better visualization of the uterine cavity. Second, it rules out the possibility of an existing pregnancy, as the examination should not be performed if conception has already occurred.
Is hysterosalpingography painful?
Hysterosalpingography may cause temporary discomfort, usually in the form of cramping low in the abdomen, similar to menstrual pain. The intensity varies from woman to woman and often depends on whether there is spasm or partial blockage of the fallopian tubes.
When it occurs, the discomfort lasts a few minutes and subsides shortly after the examination is completed. In many cases, the experience is milder than expected.
If needed, mild pain relief may be given before the examination, while modern technique and proper preparation help reduce discomfort.
Ultrasound hysterosalpingography (HyCoSy)
Ultrasound hysterosalpingography, also known as HyCoSy (Hystero-Contrast Sonography), is a modern alternative method for assessing fallopian tube patency. The examination is performed in the gynecology office using ultrasound and a special contrast agent, without radiation.
During the procedure, a special foamy or liquid contrast medium is injected through the cervix and, with the help of transvaginal ultrasound, its passage through the uterus and fallopian tubes is monitored. In this way, it is determined whether the tubes are open.
Ultrasound hysterosalpingography is considered a well-tolerated examination, with mild discomfort and short duration. At the same time, it allows evaluation of the uterine cavity and ovaries.
The choice between conventional hysterosalpingography and HyCoSy depends on the medical history, the findings of the initial evaluation, and the available facilities. Both methods have a role in the assessment of female fertility.
Pregnancy after hysterosalpingography
Many women wonder whether they can achieve pregnancy after hysterosalpingography and whether the examination affects conception.
If no tubal blockage is found and no different medical instructions are given, there is no reason to avoid trying in the same cycle. In many cases, intercourse is normally allowed after the examination is completed.
The examination does not negatively affect ovulation and does not disrupt the cycle. If it is scheduled correctly within the cycle, reproductive function continues normally.
Final guidance regarding when to resume attempts is always given on an individual basis by the treating physician.
The role of hysterosalpingography in fertility evaluation
Hysterosalpingography is a key stage in the evaluation of female infertility, as it allows assessment of fallopian tube patency—one of the most critical factors for natural conception.
Confirming that the fallopian tubes are open allows attempts to continue naturally or with mild interventions. By contrast, detecting a blockage helps guide the treatment strategy, whether this involves further evaluation or planning assisted reproduction.
Before starting in vitro fertilization, evaluation of the fallopian tubes is particularly important, as certain pathological conditions (such as hydrosalpinx) may negatively affect implantation and the success of treatment.
Hysterosalpingography is not a standalone examination, but part of a comprehensive evaluation plan that includes hormonal testing, ultrasound assessment, and, where required, further specialized tests.
Correct interpretation of the findings allows individualized planning of the next steps, with the goal of optimizing the chances of conception.
Frequently Asked Questions (FAQ)
Ultrasound hysterosalpingography (HyCoSy) is a modern method for assessing fallopian tube patency using ultrasound and a special contrast agent, without radiation. It is performed in the office and is usually well tolerated.
Hysterosalpingography does not affect ovulation or disrupt the normal cycle when it is performed at the right time within the cycle.
Yes. If the examination is performed before ovulation and there are no abnormal findings, conception in the same cycle is possible. In some cases, the chances may be increased in the first months after the examination.
Conventional hysterosalpingography does not require general anesthesia or sedation. In most cases, the examination is brief and well tolerated.
If there is increased anxiety or sensitivity to pain, the doctor may recommend mild pain relief before the procedure. In some centers, light sedation may also be available if considered necessary.
After hysterosalpingography, mild spotting or a small amount of blood may occur for one to two days. This is considered normal and is due to manipulation of the cervix and passage of the contrast medium.
In most cases, there is no restriction on intercourse after the examination, as long as there is no severe pain or other discomfort. The treating physician may provide individualized instructions depending on the medical history.
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