What is a uterine film and why is it taken?

Recurrent miscarriages, the inability to conceive, or suspicion of an underlying condition… One of the most commonly used imaging methods to identify the causes of these issues and initiate appropriate treatment is the uterine imaging procedure known as hysterosalpingography (HSG) [1].

This method is sometimes used to determine the causes of infertility and sometimes to increase the chances of pregnancy by opening blocked fallopian tubes. With advancements in medical technology, this procedure is now performed in a highly comfortable manner.

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Hysterosalpingography (HSG) serves both diagnostic and therapeutic purposes. It not only visualizes tubal patency but may also significantly increase the likelihood of spontaneous pregnancy after the procedure.

What Is Hysterosalpingography (HSG)?

Hysterosalpingography (HSG), also known as a uterine X-ray, is a procedure in which a special radiopaque contrast agent is introduced into the uterus through the cervix to visualize the uterine cavity and fallopian tubes. This method is used to detect possible narrowing, dilation, or blockage in the fallopian tubes [1].

It is performed to evaluate the shape of the uterus, detect conditions such as fibroids or polyps, and assess congenital abnormalities. Additionally, since partially blocked tubes may be opened during the procedure, it can increase the chances of pregnancy. Studies have shown that in infertility patients undergoing HSG with oil-based contrast agents, the rate of spontaneous pregnancy increases approximately threefold [2].

For more detailed information about the causes of infertility, you can visit our causes of infertility page.

In Which Situations Is HSG Performed?

HSG is primarily used to investigate the causes of infertility. It is used to visualize the fallopian tubes, which play a key role in the meeting of the egg and sperm. It is also preferred in the following situations [1]:

• To determine the cause of recurrent miscarriages
• To detect blocked fallopian tubes
• To evaluate the uterus after surgery
• To identify factors that may prevent embryo implantation
• To assess uterine and tubal anatomy before IVF or IUI treatments

How Is HSG Performed?

The patient is positioned on a gynecological examination table in a position similar to childbirth. Her legs are drawn up, and the body is covered with a sterile drape. A speculum is inserted to visualize the cervix.

Then, an antiseptic solution is applied to eliminate microorganisms and prepare the area for imaging. A thin catheter is placed into the cervical canal, and a contrast agent is injected. The fluid moves through the uterus and fallopian tubes, and X-ray images are taken at the appropriate time [1].

What Should Be Considered After the Procedure?

Since a pressurized fluid is used during the procedure, mild sensitivity or discomfort in the uterus may occur. Therefore, sexual intercourse is not recommended for 48 hours after the procedure. Additionally, extra attention should be paid to genital hygiene to prevent possible infections or allergic reactions [1].

For more detailed information about IVF treatment, you can visit our IVF treatment page.

Frequently Asked Questions (FAQ)

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  Is HSG painful?

  With modern techniques, HSG is a comfortable and quick procedure. A slight pressure or cramping sensation may be felt during the injection of the contrast agent, but this is temporary. It does not require anesthesia.

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  When should HSG be performed?

  HSG is usually performed after menstruation, between the 6th and 12th days of the cycle. During this phase, the endometrium is thinner, which improves image quality.

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  Does HSG contribute to infertility treatment?

  Yes. HSG may have both diagnostic and therapeutic effects. The pressure of the contrast agent can help open mildly blocked tubes, increasing the chances of spontaneous pregnancy.

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  Can HSG be performed before IVF?

  Yes. HSG is routinely used before IVF or IUI treatments to evaluate the uterus and fallopian tubes and detect any anatomical issues that may prevent implantation.

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  What should be avoided after HSG?

  Sexual intercourse should be avoided for 48 hours. Additionally, vaginal douching, creams, and suppositories should not be used, and proper genital hygiene should be maintained.

References

1. Deshpande, H., et al. (2024)
2. Bulut, H., et al. (2021)