When an egg is released from one of the ovaries, it travels through one of the fallopian tubes, which are narrow ducks that connect the ovaries to the uterus. Normally, the egg will join the sperm in the fallopian tubes during conception and the (now) fertilized egg will continue on to the uterus. A hysterosalpingography examines if the fallopian tubes are blocked or deformed, which may prevent the egg to descend or the sperm being blocked and preventing it from moving up to meet the egg. Approximately thirty percent of infertility cases are due to damaged or blocked fallopian tubes.
The evening before a hysterosalpingoraphy, laxative would be taken or sometimes an enema or suppositories would be administered the day of the test, which enables the doctor to examine the genital area without any fecal obstruction. Also, evening before the test, limiting the amount of food or fluids taken. The examination takes place in a hospital or office of a radiologist.
During the procedure or pelvic examination, woman would be lying on her back on a fluoroscopy table. Her feet are likely to be raised into stirrups, and her knees are adjusted closer to her chest (This is called the lithotomy position.). X-ray equipment is placed above her abdomen. A speculum (medical tube used to examine body cavities) is inserted into the vagina or vulva (female organ connecting the uterus and cervix to the outside of the body). A catheter containing a small balloon is inflated to hold it in place.
Then a liquid water-based or oil based dye ("contrast dye") is then injected through the catheter into the uterus. During this process, may cause some discomfort, cramping or uterine spams. Sometimes pain medication, such Ibuprofen (Unless the woman is allergic to this medication) is taken two hours before the Hysterosalpingoraphy, especially for women that experience severe cramps because a sensitive uterus or a sedative is administered, but no anesthesia is required. The dye travels through the reproductive tract, which is viewed on an X-ray monitor. The doctor can observe for any blockages or abnormalities, and several x-rays are taken, which will be developed and viewed with scrutiny, for final reading and interpretation. If the fallopian tubes are open the dye will fill the tubes and spill out into the abdominal cavity (The abdominal cavity contains organs including liver, gallbladder, spleen, pancreas, urinary bladder, small and large intestines). Otherwise, abnormality may show leak of the dye from the uterus.
This type of pelvic examination takes approximately 15 - 30 minutes. In some cases, the hysterosalpingography procedure is used to open small blockages in the fallopian tubes. After the procedure, the woman is observed for any allergic reactions from the dye or bleeding for about 30 minutes. Sanitary napkin maybe worn absorb, dye that flows through the vaginal opening. Also, if any excessive bleeding occurs, extensive pelvic pain or unpleasant vaginal pain occurs, the woman's physician should be notified. An antibiotic would be prescribed for treating any blockage that was observed. The doctor would discuss with the patient, if any additional procedure would be recommended to treat tubal blockage or uterine abnormalities. This procedure does not always detect all possible abnormalities of the fallopian tubes or uterus.
Hysterosalpingoraphy will diagnose: Uterine tumors, intrauterine adhesion (Pelvic adhesion, Intraperitoneal adhesion or Intrauterine adhesion: Fibrous bands of scale like tissue that form between two surfaces inside the body), developmental disorders, obstruction of the fallopian tubes, traumatic injury, tubal adhesions (Appear as cobwebs on the surface of fallopian tube and ovaries, which prevent eggs successful ovulation, thus preventing the tubes from picking up eggs and limiting mobility of the tubes. Caused by IUD's, abdominal problems including appendicitis or ovarian cyst removal. Presence of any adhesions removed by scissor, cautery or a laser. Those women under the age of fifty-one will respond better to treatment), presence of foreign bodies, pregnancy outside of the uterus (Ectopic pregnancy, Tubal pregnancy; Cervical pregnanc or Abdominal pregnancy: Occurs when fertilized egg implants in tissue outside of the uterus, and development begins of the placenta and fetus.) and scarring.
Hysterosalpingography should not be done if a women suspects she might be pregnant, have pelvic inflammatory disease, experiencing unexplained vaginal bleeding or currently menstruating. Often the test is scheduled one week following a woman's period to ensure not being pregnant or a pregnancy test is scheduled. Also, women that have had allergic reaction to the dye should inform their doctor, before undergoing this procedure.
Some research suggestions but is not conclusively proven: Oil based instead of water based
Dye could increase fertility during the following six months after hysterosalpinography.