HSG (Hysterosalpingogram)

HSG After Tubal Reversal Surgery

I can't begin to thank Dr. Berger and staff for the "miracle" procedure that gave me my son.

"I had my TR done in January. After months of trying we had an HSG in August and I got pregnant right after that."
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If you are not pregnant within 6-12 months following your tubal reversal surgery, Dr. Berger will recommend an HSG (hysterosalpingogram). Although hysterosalpingography is the most widely available test for assessing tubal patency, the results often are inconclusive or interpreted inaccurately. This is especially true in cases where the dye does not reach the tubal anastomosis sites in the fallopian tubes due to tubal spasm.

To assist you, we have compiled a list of tips to remember when preparing for your HSG. It is a good idea to discuss them with the doctor who orders the HSG and the doctor performing the test. Following your HSG, please instruct the radiologist to send a copy of the x-ray films as well as the typed report to Dr. Berger to review and compare with your tubal reversal operative report.

Tips For HSG Testing

An HSG should be performed after your period and prior to ovulation – usually between cycle days 7 through 10. It should never be performed after your LH surge or ovulation, since it could interrupt a very early conception.
Ask your doctor to prescribe a prophylactic antibiotic - such as Doxycycline 100 mg twice a day to start 2 days prior to the HSG and to continue for a total of 5 days. Dr. Berger also recommends using a betadine vaginal douche the night before and immediately prior to going to your appointment for the HSG. These minimize the low risk of infection resulting from the procedure.
Take an analgesic such as Motrin or Extra Strength Tylenol before going for the x-ray procedure.
The infusion of the x-ray dye into the uterus should be done slowly and under fluoroscopic monitoring. Rapid distension of the uterus with the x-ray dye can cause tubal spasm that prevents any dye from entering the fallopian tubes. If no dye enters the tube, it cannot be determined whether the anastomosis site is open or blocked and the examination will be inconclusive.
During the HSG x-ray, if dye does not enter both fallopian tubes, do not assume the tubes are blocked. Have your doctor stop injecting the dye for a minute so that you may rest a few seconds, rock hips from side to side, and then the doctor should begin injecting the dye again.
Use enough dye. Often the uterus will fill and dye will go part way into the tubes and stop. Sometimes the lack of tubal fill is because there wasn't enough dye injected and not because the tube is actually blocked! Some of the dye may also leak back out through the cervical canal making it more difficult to get the tubes to fill with the x-ray dye.

Please stay in touch with our nurses and let us know if you have any questions. Remember, if the doctor/radiologist tells you that your tubes are blocked, don't panic. In many cases it could be a problem with the testing rather than a problem with the tubes.

Excerpt From Tubal Reversal Message Board

"We had a patient that came all the way here for a repeat surgery today because her HSG reported that the tubes were blocked. At her second surgery, hydrotubation showed her tubes to be WIDE OPEN! This is, of course, GREAT NEWS but it would have been so nice if her HSG had been done properly so that she could have saved the trip."

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