Hysterosalpingography (HSG)

Hysterosalpingography (HSG) – Estimated Cost

The cost of hysterosalpingography may vary depending on the diagnostic center or hospital, imaging technology used, contrast material, patient condition, and the expertise of the radiology team. Below are approximate costs for hysterosalpingography in India, Turkey, Thailand, and Dubai:

Note: Above costs for hysterosalpingography are estimated. Reach out to EdhaCare for exact cost and personalized guidance.

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EdhaCare introduces the best hospitals in India for hysterosalpingography, helping patients access the top hospitals for hysterosalpingography in India with advanced imaging facilities and expert gynecological care.

Renowned Doctors in India for Hysterosalpingography

Connect with the best doctors in India for hysterosalpingography, selected by EdhaCare for their diagnostic expertise. These top doctors for hysterosalpingography in India ensure accurate evaluation and patient safety.

Who Needs Hysterosalpingography?

HSG is recommended in women who are being assessed for infertility or have a suspicion of uterine or tubal abnormality. The following are general indications for HSG:

• The inability to conceive after 1 year of unprotected intercourse (6 months in >35 years of age)
• Suspected blocked fallopian tubes
• History of pelvic infections (Pelvic Inflammatory Disease - PID)
• History of recurrent miscarriages
• Suspected womb anomalies, like a septate or bicornuate womb 
• History of tubal surgery or ectopic pregnancy
• Follow-up imaging after a reversal of tubal ligation

HSG is commonly done in the timeframe of Day 7 to Day 12 (Day 1 being the first day of menstruation) in the menstrual cycle to limit the possibility of interfering with a potential pregnancy.

Types of Hysterosalpingography Procedures

There are two primary types of HSG established based on imaging modality:

Conventional HSG (X-ray Based)

In this procedure, radiopaque contrast dye, usually an iodinated solution, is injected through the cervix into the uterus and then through the fallopian tubes while performing fluoroscopy (real-time X-ray). Conventional HSG is the most commonly used method in the world.

Sonohysterography (Saline Infusion Sonohysterography)

Sonohysterography involves using a saline infusion instead of a contrast dye and ultrasound instead of X-rays. It provides excellent images of the uterine cavity and helps detect abnormalities. 

Digital Subtraction Angiography (DSA) HSG

This is an advanced technique using digital imaging technology and involves injecting contrast dye and using a computer to subtract the background structures. It enables clearer images of the fallopian tubes and uterus. 

Conventional HSG will be the test of choice for the first step in assessing the uterus and fallopian tubes in the evaluation of infertility.

Pre-Treatment Evaluation and Diagnostics

Before a patient receives an HSG, the following recommendations and considerations will be made:

• Confirmation of menstruation: An HSG is performed in the pre-ovulatory phase, ideally between menstrual cycles. The goal is to ensure that the patient is not pregnant.
• Infection Control: The physician will examine the potential for active vaginal or pelvic infections to decrease the chance of spreading infection during the procedure.
• Pregnancy Test: The patient will be tested for pregnancy to rule out any early pregnancy.

Patients will be advised to take a mild pain reliever (i.e., ibuprofen) no longer than 30–60 minutes before the study to reduce discomfort.

Selection and Procedure Planning

HSG is routinely performed in fertility clinics, radiology centers, and hospitals that have fluoroscopic imaging facilities. Planning includes:

• Ensuring the study is ordered at the right time during the menstrual cycle.
• Preparing the patient for the procedure (i.e., what the procedure entails and how it feels).
• Confirm the patient does not have active pelvic/vaginal infections.

In selected cases, prophylactic antibiotics are used if there is a history of pelvic inflammatory disease.

In general, the procedure will be ordered as an outpatient test, without sedation.

Hysterosalpingography Procedure

The HSG procedure typically takes 15 to 30 minutes and is performed in a radiology suite or specialized procedure room.

Step-by-Step Process

1. Positioning: The patient lies on an X-ray table with the legs abducted and hips flexed while being supported by leg holders or stirrups (similar to a pelvic exam).
2. Cervical Preparation: A speculum is inserted to visualize the cervix. 
3. Catheter Insertion: A thin, flexible catheter is inserted through the cervical canal into the uterus.
4. Dye Injection: A contrast dye (usually iodine-based) is slowly injected into the uterine cavity.
5. Imaging: X-ray images (fluoroscopy) are taken to track the flow of dye through the uterus and fallopian tubes.
6. Assessment: The radiologist assesses whether the dye spills out of the ends of the fallopian tubes, indicating an open and unobstructed state of the fallopian tubes, which is necessary for natural conception.
7. Completion: The catheter and speculum are removed, and the patient can resume normal activities shortly after.

Risks & Potential Complications of Hysterosalpingography

Hysterosalpingography is generally safe, but as with all medical procedures, there are potential risks and complications:

• Mild cramping or abdominal discomfort during or shortly after the procedure
• Light vaginal spotting for 1–2 days
• Infection (especially in women with a history of pelvic inflammatory disease)
• Allergic reaction to the contrast dye (rare)
• Uterine perforation (extremely rare)
• Radiation exposure (minimal and considered safe)

To minimize risks, appropriate pre-procedure screening and post-procedure care instructions are provided.

What to Expect After Hysterosalpingography?

After the procedure, most patients can resume normal activities immediately. Post-procedure expectations include:

• Mild Cramping: Usually resolves within a few hours.
• Light Bleeding: Occasional spotting may occur for 1–2 days.
• Discharge: Some leakage of the contrast dye is normal.

Patients are advised to contact their healthcare provider if they experience:

• Persistent pain
• Heavy bleeding
• Fever
• Foul-smelling vaginal discharge

A follow-up consultation is typically scheduled to review the HSG findings and plan the next steps in fertility treatment.

Post-Treatment Recovery & Long-Term Care

Post-procedure recovery is usually quick and uncomplicated. Long-term care involves:

• Review of Results: Based on HSG findings, the fertility specialist will recommend further treatments such as ovulation induction, intrauterine insemination (IUI), or IVF.
• Treatment Adjustment: If tubal blockage is identified, surgical intervention or IVF may be suggested.
• Infection Prevention: Patients may be prescribed antibiotics if there is a concern about infection risk.
• Repeat Imaging (if needed): Rarely, a second HSG or alternative imaging like laparoscopy may be required to confirm results.

In some cases, HSG itself may temporarily improve fertility by flushing out minor blockages in the fallopian tubes.

Hysterosalpingography Success Rate in India

HSG is a diagnostic test, not a treatment, but it plays a critical role in the successful management of infertility. Key statistics and observations include:

• Accuracy in Detecting Tubal Blockage: 85-90%
• Diagnostic Value for Uterine Abnormalities: Identifies septa, polyps, fibroids, and adhesions effectively
• Potential to Improve Conception Rates: Some studies suggest that HSG may increase natural conception rates temporarily by flushing the tubes

India’s top fertility clinics and radiology centers offer HSG with high diagnostic accuracy, minimal discomfort, and safe procedural protocols.

Why Choose India for Hysterosalpingography?

India offers affordable, safe, and high-quality Hysterosalpingography services with state-of-the-art imaging equipment and expert radiologists.

• Affordable diagnostic packages compared to Western countries
• Highly skilled radiologists and fertility specialists
• Access to modern fluoroscopy units with minimal radiation exposure
• Integration with comprehensive fertility services, including IUI, IVF, and laparoscopy
• Rapid scheduling and minimal waiting time
• Supportive care for international patients, including medical visa facilitation

Required Documents for Patients Traveling to India for Hysterosalpingography

For international patients planning to undergo HSG in India, certain documents are required to ensure a hassle-free medical trip. These include:

• Valid Passport: Must be valid for at least six months from the date of travel.
• Medical Visa (M Visa): Issued by the Indian Embassy/Consulate based on medical necessity.
• Invitation Letter from Indian Hospital: A confirmation from the hospital outlining the treatment plan and duration.
• Recent Medical Records: Including X-rays, MRIs, blood reports, and a doctor’s referral from the home country.
• Completed Visa Application Form: Along with passport-size photographs as per specifications.
• Proof of Financial Means: Recent bank statements or health insurance coverage.
• Medical Attendant Visa: Required for a companion or caretaker traveling with the patient.

It's recommended to consult the Indian consulate or your medical facilitator for updated guidelines and assistance with documentation.

NOTE: Single parents and same-sex couples should confirm legal requirements with the clinic before starting.

Frequently Asked Questions (FAQs)

Is HSG a painful procedure?

HSG may cause mild cramping similar to menstrual cramps, but the discomfort is usually brief and manageable with over-the-counter painkillers.

How long does the HSG procedure take?

The entire procedure typically takes 15–30 minutes.

Can I get pregnant after HSG?

Yes. Some women conceive naturally within a few months of an HSG, possibly due to the flushing effect of the dye on the fallopian tubes.

When is the best time to have an HSG?

HSG is best performed between Days 7 and 12 of the menstrual cycle to avoid disrupting a potential early pregnancy.

Are there any side effects of HSG?

Minor cramping and light spotting are common side effects. Serious complications like infection are rare.