Hysterosalpingography (HSG) Test at Chughtai Lab

Hysterosalpingography (HSG) at Chughtai Lab

Hysterosalpingography (HSG) is a specialized, minimally invasive fluoroscopic X-ray examination primarily utilized in reproductive medicine to evaluate the structural integrity of the uterine cavity and the patency of the fallopian tubes. By utilizing a water-soluble iodinated contrast medium, this diagnostic procedure provides real-time, high-resolution visualization of the female reproductive tract. At Chughtai Lab, Pakistan’s leading diagnostic network, the HSG test is conducted using state-of-the-art digital fluoroscopy equipment under the supervision of highly qualified female radiologists and trained technologists. This ensures the highest standards of diagnostic accuracy, patient safety, and clinical comfort.

The fallopian tubes and uterine cavity play a critical role in natural conception. The uterus must provide a receptive environment for embryo implantation, while the fallopian tubes must be open and functional to allow the sperm to reach and fertilize the egg, and subsequently transport the fertilized embryo back to the uterine cavity. Any structural abnormality, such as fallopian tube blockage, uterine fibroids, endometrial polyps, or congenital uterine anomalies, can significantly impair fertility or lead to recurrent pregnancy loss. Consequently, the HSG test serves as a cornerstone investigation in the initial workup of female infertility. It offers invaluable clinical insights that guide gynecologists, obstetricians, and reproductive endocrinologists in formulating effective treatment plans, whether involving medical management, surgical intervention, or assisted reproductive technologies (ART) such as Intrauterine Insemination (IUI) or In Vitro Fertilization (IVF). By choosing Chughtai Lab, patients across Pakistan benefit from a legacy of diagnostic excellence, compassionate care, and highly reliable reporting.

Clinical Procedure: What to Expect

Patient Preparation

Proper patient preparation is essential to ensure the safety, comfort, and diagnostic accuracy of a Hysterosalpingography (HSG) at Chughtai Lab. Patients are advised to adhere strictly to the following clinical guidelines:

• Optimal Timing: The HSG test must be scheduled during the follicular phase of the menstrual cycle, specifically between day 7 and day 10. This window is calculated starting from the first day of menstrual bleeding. Performing the test during this period ensures that menstruation has completely ceased, the endometrial lining is thin (which prevents false-positive findings from thick tissue), and the patient is not pregnant.
• Pregnancy Screening: A pregnancy test (either a urine test or a serum beta-hCG test) is mandatory prior to the procedure. HSG uses ionizing radiation and radiographic contrast, which are strictly contraindicated during pregnancy due to potential risks to the developing fetus.
• Infection Screening: The procedure cannot be performed if there is any active pelvic infection, pelvic inflammatory disease (PID), or unexplained vaginal discharge. Patients should inform their doctor if they experience symptoms of infection.
• Allergy Notification: Patients must inform the clinical team of any known allergies, particularly to iodine, radiographic contrast media, shellfish, or specific medications.
• Pain Management: To minimize the mild to moderate uterine cramping that often accompanies the injection of contrast, patients may be advised by their physician to take an over-the-counter nonsteroidal anti-inflammatory drug (NSAID), such as ibuprofen, 30 to 60 minutes before the procedure.
• Antibiotic Prophylaxis: In some clinical scenarios, particularly if there is a history of pelvic infection, the referring physician may prescribe a short course of prophylactic antibiotics to be started before or on the day of the test.
• Bladder Preparation: Patients should empty their bladder immediately before the procedure. A full bladder can displace the uterus and obscure pelvic structures on the fluoroscopic images.
• Comfortable Clothing: Wear loose, comfortable clothing. You will be asked to change into a sterile hospital gown before entering the fluoroscopy room.

During the Procedure

Understanding what happens during a Hysterosalpingography (HSG) at Chughtai Lab can significantly reduce patient anxiety. The procedure is performed in a dedicated fluoroscopy suite and typically proceeds as follows:

• Positioning: The patient is asked to lie down on the fluoroscopy table in the lithotomy position, with feet placed in stirrups, similar to a routine gynecological examination.
• Aseptic Preparation: The radiologist inserts a sterile speculum into the vagina to visualize the cervix. The cervix and vaginal walls are thoroughly cleansed with an antiseptic solution (such as betadine) to minimize the risk of introducing bacteria into the uterine cavity.
• Catheter Insertion: A thin, sterile, flexible catheter (or a metal cannula) is gently passed through the cervical opening (os) into the uterine cavity. A tiny balloon at the tip of the catheter may be inflated with a small amount of sterile water to secure the catheter in place and prevent the contrast medium from leaking back into the vagina.
• Contrast Administration: The speculum is carefully removed, and the patient is positioned beneath the fluoroscopy machine. The radiologist slowly injects a warm, water-soluble iodinated contrast medium through the catheter. The contrast flows into the uterine cavity, travels through the fallopian tubes, and, if the tubes are open, spills out into the pelvic cavity.
• Fluoroscopic Imaging: The radiologist monitors the flow of contrast in real-time on a digital monitor. Multiple X-ray images are captured at specific intervals: as the uterus fills, as the fallopian tubes fill, and when the contrast spills into the peritoneal cavity. The patient may be asked to shift position slightly (e.g., tilt to the left or right) to obtain optimal views of the pelvic anatomy.
• Sensation and Experience: During the injection of the contrast, patients commonly experience a sensation of pelvic pressure or cramping, which resembles menstrual cramps. This is a normal physiological response to the distension of the uterine cavity. The cramping is temporary and usually subsides shortly after the catheter is removed.
• Completion: Once all necessary images are obtained, the catheter balloon is deflated, the catheter is removed, and the procedure is complete. The entire process takes approximately 15 to 30 minutes. The patient is provided with sanitary pads, as minor vaginal spotting and leakage of the contrast fluid are common for a short period after the test.

When is a Hysterosalpingography (HSG) Performed?

Evaluation of Female Infertility

Female infertility is a complex clinical condition defined as the inability to conceive after 12 months or more of regular, unprotected intercourse. Tubal and uterine factors account for a significant proportion of female infertility cases. Physicians request a Hysterosalpingography (HSG) at Chughtai Lab as a primary diagnostic tool to evaluate these anatomical factors. The test provides crucial visual evidence of whether the reproductive tract is structurally capable of supporting natural conception, helping clinicians determine if further fertility treatments are required.

Assessment of Fallopian Tube Patency

The fallopian tubes are the essential conduits where fertilization occurs. If these tubes are blocked, scarred, or damaged due to conditions like pelvic inflammatory disease (PID), endometriosis, or previous pelvic surgeries, the sperm cannot reach the egg. An HSG is specifically performed to assess fallopian tube patency. By observing the flow and spill of radiographic contrast, radiologists can determine if one or both tubes are blocked, allowing fertility specialists to plan targeted interventions.

Detection of Uterine Cavity Abnormalities

Successful pregnancy requires a healthy uterine environment where an embryo can implant and grow. Structural abnormalities within the uterine cavity can prevent implantation or lead to early pregnancy loss. An HSG is performed to detect intrauterine pathologies such as endometrial polyps, submucosal uterine fibroids, congenital uterine septa, and intrauterine adhesions (Asherman’s syndrome). Identifying these abnormalities allows for corrective hysteroscopic surgeries to improve reproductive outcomes.

Investigation of Recurrent Miscarriages

Recurrent miscarriage, defined as two or more consecutive pregnancy losses, is a deeply distressing clinical challenge. Congenital uterine anomalies (such as a septate, bicornuate, or didelphys uterus) and acquired uterine defects are strongly associated with recurrent miscarriages. An HSG is requested by gynecologists to thoroughly evaluate the shape and volume of the uterine cavity, helping to identify structural causes of pregnancy loss and guide surgical or medical management.

Post-Surgical Evaluation of Tubal Procedures

Patients who have undergone tubal surgeries, such as tubal ligation reversal, surgical repair of blocked tubes (salpingostomy), or the placement of hysteroscopic tubal occlusion devices, require objective confirmation of the surgical outcome. An HSG is performed post-operatively to verify whether the fallopian tubes have been successfully opened or, in the case of sterilization, completely occluded, ensuring the efficacy and safety of the procedure.

What Does a Hysterosalpingography (HSG) Detect?

An HSG is a highly sensitive diagnostic imaging test capable of detecting a wide range of anatomical and pathological conditions within the female reproductive system. The key findings that can be identified during an HSG at Chughtai Lab include:

• Bilateral fallopian tube patency (normal, open tubes)
• Unilateral fallopian tube occlusion (blockage in one tube)
• Bilateral fallopian tube occlusion (blockage in both tubes)
• Hydrosalpinx (dilated, fluid-filled fallopian tube)
• Proximal tubal obstruction (blockage near the uterus)
• Distal tubal obstruction (blockage near the fimbrial end)
• Uterine synechiae or intrauterine adhesions (Asherman’s syndrome)
• Endometrial polyps (benign growths in the uterine lining)
• Submucosal uterine fibroids (non-cancerous tumors bulging into the cavity)
• Septate uterus (a congenital anomaly where a band of tissue divides the uterus)
• Bicornuate uterus (a heart-shaped uterus)
• Unicornuate uterus (a uterus that channelizes only on one side)
• Uterus didelphys (double uterus)
• T-shaped uterine cavity (associated with diethylstilbestrol exposure)
• Salpingitis isthmica nodosa (nodular scarring of the fallopian tubes)
• Pelvic adhesions restricting the free spill of contrast
• Contrast extravasation into pelvic blood vessels or lymphatics
• Uterine cavity distortion or compression from external masses
• Cervical canal stenosis (narrowing of the cervix)
• Congenital absence of one or both fallopian tubes
• Tubal phimosis (narrowing of the tubal opening)
• Loculated contrast spill (contrast pooling in a localized area)
• Intrauterine foreign bodies (such as displaced intrauterine devices)
• Post-surgical scarring or changes in the pelvic cavity
• Endometrial hyperplasia (suggested by irregular cavity margins)

Turnaround Time and Report Access at Chughtai Lab

At Chughtai Lab, we understand that waiting for diagnostic results can be an anxious time for patients and their families. We are committed to providing rapid, accurate, and highly reliable diagnostic reporting. Following your Hysterosalpingography (HSG) procedure, the captured digital fluoroscopy images are carefully reviewed by our expert consultant radiologists. A comprehensive, detailed diagnostic report is generated, detailing the structural findings of your uterine cavity and fallopian tubes. The finalized report and high-resolution digital images are typically available within 24 to 48 hours.

Chughtai Lab offers seamless digital access to your medical records. Patients receive an SMS notification with a secure link as soon as their report is ready. Reports and images can be viewed, downloaded, and shared directly through the official Chughtai Lab mobile application or the secure online patient portal on our website. For patients who prefer physical copies, printed reports and imaging films can be collected from any of our extensive network of diagnostic centers and collection points located across Lahore, Karachi, Islamabad, Peshawar, Multan, Faisalabad, and other major cities throughout Pakistan.

Hysterosalpingography (HSG) Findings Overview

Structure / Parameter Evaluated	Normal Findings	Possible Abnormal Findings
Uterine Cavity Shape	Triangular, smooth contours, symmetrical margins	Septate, bicornuate, unicornuate, didelphys, or T-shaped cavity
Uterine Cavity Filling	Homogeneous filling without filling defects	Filling defects indicating polyps, submucosal fibroids, or synechiae
Fallopian Tube Patency	Free flow of contrast through both tubes	Unilateral or bilateral tubal occlusion, lack of contrast flow
Fallopian Tube Caliber	Thin, delicate, uniform caliber	Dilated, tortuous tubes (hydrosalpinx) or nodular thickening
Peritoneal Contrast Spill	Free, diffuse, homogeneous spill into the pelvic cavity	Absent spill, loculated or restricted spill indicating pelvic adhesions
Cervical Canal	Normal width and smooth mucosal pattern	Cervical stenosis, irregular contours, or excessive widening
Contrast Extravasation	No intravasation into uterine veins or lymphatics	Venous or lymphatic intravasation, often due to high injection pressure

Note: Diagnostic findings should always be interpreted by a qualified healthcare professional together with the patient’s symptoms, medical history, physical examination, laboratory investigations, previous imaging studies, and other relevant clinical information. Additional investigations or specialist consultation may be recommended depending on the findings.

Why Choose Chughtai Lab for Hysterosalpingography (HSG)?

• Experienced Female Radiologists: We prioritize your privacy and comfort by ensuring that all HSG procedures are performed by highly qualified female radiologists and female clinical staff.
• State-of-the-Art Fluoroscopy Systems: Our diagnostic centers are equipped with advanced digital fluoroscopy technology that provides exceptional image resolution with minimal radiation exposure.
• Strict Infection Control Protocols: We adhere to rigorous international sterilization and hygiene standards to prevent any risk of pelvic infection during the procedure.
• Extensive National Network: With diagnostic facilities across major cities in Pakistan, including Lahore, Karachi, and Islamabad, accessing premium healthcare is convenient and close to home.
• Seamless Digital Report Access: Patients can instantly access, download, and share their diagnostic reports and high-resolution images via the Chughtai Lab app or online portal.
• Trusted Healthcare Legacy: Serving Pakistan since 1983, Chughtai Lab is a household name trusted by millions of patients and thousands of medical specialists for diagnostic accuracy.
• Compassionate Patient Care: Our dedicated clinical team provides empathetic support, guiding you through every step of the procedure to ensure a stress-free and comfortable experience.
• Integrated Diagnostic Services: We offer a complete range of reproductive health diagnostics, including hormone profiles, semen analysis, and pelvic ultrasounds, allowing for comprehensive clinical evaluation under one roof.