Master, Doctor Nguyen Xuan Anh Duy, from the Assisted Reproductive Unit at Tam Anh Cau Giay General Clinic, explains that hysterosalpingography (HSG) is an X-ray technique. It involves injecting a contrast dye into the uterine cavity to examine the uterus's shape and the patency of the fallopian tubes. This procedure helps diagnose infertility, uterine malformations, and blocked fallopian tubes.

One common scenario for HSG is when couples have regular, unprotected intercourse for one year (or six months for women over 35) without conceiving. In such cases, doctors assess whether blocked fallopian tubes are preventing sperm from reaching the egg for natural conception.

In assisted reproductive technology, HSG is a crucial diagnostic step. It helps determine subsequent treatment plans, such as natural cycle monitoring, intrauterine insemination (IUI), or in vitro fertilization (IVF).

Doctors also recommend HSG when they suspect uterine cavity abnormalities, including uterine adhesions, polyps, submucosal fibroids, uterine malformations, or scarring from previous infections, abortions, or surgeries. Additionally, it is considered for women with recurrent miscarriages to identify structural issues affecting embryo implantation and pregnancy maintenance.

Patients who have undergone fallopian tube surgery, tubal ligation, or recanalization procedures may also require a follow-up HSG to evaluate the outcomes.

A doctor consults with a patient after hysterosalpingography. *Photo: Tam Anh Cau Giay General Clinic*

However, HSG is not indicated for all women experiencing infertility. Doctors typically postpone the procedure if a patient has ongoing gynecological infections, pelvic inflammatory disease, untreated sexually transmitted infections, abnormal bleeding, or suspected pregnancy. HSG is a minimally invasive procedure that could increase infection risk or cause complications if performed at an inappropriate time.

The most suitable time for HSG is usually one to three days after menstruation ends, before ovulation, and when pregnancy is unlikely in that cycle. Performing the procedure at the correct time ensures clearer images and reduces the risk of complications if the patient is unknowingly pregnant.

Before the procedure, patients are usually advised to abstain from intercourse from the start of their menstrual cycle until the HSG. In some cases, doctors may prescribe pain relievers or prophylactic antibiotics. The procedure itself causes only mild discomfort or cramping during contrast dye injection, especially if the fallopian tubes spasm or are blocked; this sensation typically subsides quickly. After the HSG, patients might experience mild abdominal pain or light vaginal discharge or bleeding for one or two days.

According to Doctor Anh Duy, in addition to conventional HSG, hysterocontrast sonography (HyFoSy), which uses ultrasound with contrast gel, can be performed to detect signs of fallopian tube blockage with comparable effectiveness.

For couples who have been trying to conceive for a long time, have a history of pelvic infections, gynecological surgery, or recurrent miscarriages, timely examination of the uterine cavity and fallopian tubes can help doctors quickly identify abnormalities and recommend appropriate treatment plans.

Van Anh