Hysterosalpingography Test: A Complete Guide for Chennai Patients

A hysterosalpingography test is a radiographic examination of the uterine cavity and fallopian tubes. A radio-opaque contrast medium is injected through the cervical canal, and X-ray images are captured as the dye outlines the uterus and travels through the tubes. According to a 2025 study in the International Journal of Reproduction, Contraception, Obstetrics and Gynecology, the hysterosalpingography test is a valuable first-line radiological screening test in the infertility work-up, used to look at the uterine cavity and check that the tubes are open.

The procedure is sometimes called a hysterosalpingogram, and the two terms refer to the same test. It is non-surgical, takes 15 to 30 minutes, and is performed in a radiology or fertility clinic setting. Understanding what the test involves can make the experience considerably less daunting, and the team at Jananam walks every patient through each step before the procedure begins.

The hysterosalpingography test is recommended as a first-line investigation for women undergoing fertility evaluation, particularly to assess whether the fallopian tubes are open and whether the uterine cavity is normal. As the 2025 IJRCOG study concludes, it is an effective first-line radiological screening test for primary and secondary infertility. It is typically scheduled between day 5 and day 14 of the menstrual cycle to avoid exposing an early pregnancy to radiation and to ensure the endometrial lining is thin enough for clear imaging.

Your consultant will usually recommend a hysterosalpingography test in the following situations: you have been trying to conceive for 12 months or more without success (or 6 months if you are over 35), you have a history of pelvic infection or previous abdominal surgery, you have experienced recurrent miscarriages, or you are about to begin IUI or IVF and a baseline assessment of tubal anatomy is needed.

The test is also part of a broader ovarian reserve and fertility evaluation at Jananam, where it is combined with blood tests such as AMH (anti-Mullerian hormone, a marker of egg supply) and a baseline ultrasound scan to give a complete picture of reproductive health.

The hysterosalpingography test follows a clear sequence of steps, and knowing what happens at each stage helps reduce anxiety on the day. The procedure is performed in a radiology suite or a dedicated fertility imaging room, and the entire appointment from preparation to discharge usually takes under an hour.

Before the procedure, your consultant will confirm the timing within your cycle and may prescribe a short course of antibiotics to reduce the small risk of infection. You will be asked to take a mild over-the-counter painkiller such as ibuprofen 30 to 60 minutes beforehand to ease cramping. You should arrange for someone to accompany you home, as some women feel lightheaded afterwards.

During the procedure, you lie on an X-ray table in a position similar to a routine gynaecological examination. A speculum is inserted, the cervix is cleaned, and a thin catheter is passed gently through the cervical canal into the uterine cavity. Contrast dye is then injected slowly while a series of X-ray images, called fluoroscopic images, are taken in real time. The radiologist or fertility specialist watches the dye fill the uterus and flow through each tube. The catheter is then removed. According to the IJRCOG study, standard HSG involves contrast injection followed by X-ray imaging to assess uterine morphology and tubal patency.

After the procedure, you will rest for 15 to 20 minutes. Light spotting and mild cramping for the rest of the day are normal. You should avoid unprotected intercourse until any prescribed antibiotics are completed, and you should contact the clinic if you develop a fever, heavy bleeding, or worsening pelvic pain.

• Stage: Preparation · What Happens: Painkiller taken, antibiotics if prescribed, consent signed · Approximate Duration: 30 minutes before
• Stage: Positioning · What Happens: Patient lies on X-ray table, speculum inserted · Approximate Duration: 5 minutes
• Stage: Catheter placement · What Happens: Thin catheter passed through cervix into uterus · Approximate Duration: 2 to 5 minutes
• Stage: Contrast injection and imaging · What Happens: Dye injected, fluoroscopic X-rays taken as dye flows through uterus and tubes · Approximate Duration: 5 to 10 minutes
• Stage: Recovery · What Happens: Rest, monitoring for immediate side effects · Approximate Duration: 15 to 20 minutes

Most women experience mild to moderate cramping during the hysterosalpingography test, similar in character to period pain. The discomfort is caused by uterine distension as the contrast dye fills the cavity and by tubal spasm as the dye enters the fallopian tubes. Pain intensity varies between patients and between clinics.

The sharpest sensation, if any, usually occurs during the 30 to 60 seconds when the dye is being injected. For most women, the discomfort is short-lived and settles within a few hours of leaving the clinic. Many clinics advise a simple painkiller such as ibuprofen or paracetamol 30 to 60 minutes beforehand, although a Cochrane review found no clear evidence that oral painkillers reduce pain during HSG. Your consultant at Jananam will advise on the right option for you based on your medical history.

Women who have never been pregnant, those with a narrow cervical canal, or those with tubal blockages may find the procedure more uncomfortable because higher pressure is needed to push the dye through. If you are particularly anxious, let the team know in advance: the radiographer can pause at any point, and the procedure can be stopped if you are in significant distress. Emotional support from a partner or family member in the waiting area also makes a meaningful difference.

Hysterosalpingography test results fall into a few clear categories, and each one points toward a different next step in your fertility journey. As described in the IJRCOG study, results may show normal tubal patency, unilateral or bilateral tubal blockage, or uterine abnormalities such as a bicornuate uterus (heart-shaped uterus), arcuate uterus (mild indentation at the top), intrauterine adhesions (synechiae), fibroids, polyps, or hydrosalpinx (a fluid-filled blocked tube).

Normal result: both tubes are open and the uterine cavity is regular in shape. This is reassuring, and your consultant will use this information alongside other test results to plan the most appropriate fertility treatment, whether that is timed intercourse, IUI, or IVF.

Tubal blockage: if one or both tubes appear blocked, the location of the blockage matters. A proximal blockage (near the uterus) can sometimes be caused by tubal spasm during the procedure rather than a true anatomical block, and a repeat test or further investigation such as laparoscopy may be recommended. A distal blockage (near the ovary) is more likely to be structural. Bilateral blockage typically means that natural conception is not possible, and IVF becomes the recommended path. Hydrosalpinx, a specific type of distal blockage where the tube fills with fluid, is associated with lower IVF success rates and may need to be treated surgically before embryo transfer.

Uterine abnormalities: findings such as a septum, polyp, or fibroid distorting the cavity may be contributing to implantation failure or recurrent miscarriage. Many of these can be corrected with a minor hysteroscopic procedure before fertility treatment begins. Your consultant will explain what each finding means for your specific situation and what the recommended next steps are.

• Finding: Both tubes open, normal uterus · What It Means: No structural barrier to conception · Typical Next Step: Proceed with planned fertility treatment
• Finding: Unilateral tubal blockage · What It Means: One tube is open; natural conception may still be possible · Typical Next Step: Further investigation or IUI using the open side
• Finding: Bilateral tubal blockage · What It Means: Both tubes are blocked; natural conception is not possible · Typical Next Step: IVF recommended
• Finding: Hydrosalpinx · What It Means: Fluid-filled blocked tube that can impair implantation · Typical Next Step: Surgical treatment before IVF
• Finding: Uterine septum or adhesions · What It Means: Structural issue that may affect implantation or increase miscarriage risk · Typical Next Step: Hysteroscopic correction before fertility treatment
• Finding: Proximal blockage only · What It Means: May be tubal spasm rather than true blockage · Typical Next Step: Repeat HSG or laparoscopy to confirm

The hysterosalpingography test is generally safe, but it carries a small number of risks that every patient should be aware of before consenting. The most important safety consideration relates to the type of contrast dye used. Oil-soluble contrast medium (OSCM), such as Lipiodol, is associated with a higher pregnancy rate after the procedure but also with prolonged iodine exposure. According to a 2022 study published via PubMed Central, OSCM use caused subclinical hypothyroidism (mildly underactive thyroid) in 38% of the 196 women followed, almost all of it mild, and the authors say regular thyroid tests are needed for 6 months after the procedure.

A further study published in Frontiers in Endocrinology in 2024, following the same 196 women, found that those with moderate iodine deficiency at baseline were 64% more likely to become pregnant after OSCM HSG, and the authors suggest the iodine from the contrast may contribute to the improved fertility seen with this procedure. Among women under 40 with subclinical hypothyroidism, those who took levothyroxine had higher pregnancy rates than those who did not (63% against 37%), although this was an observational finding and not a trial. Your consultant will discuss whether thyroid monitoring is appropriate for you based on your baseline thyroid function and the type of contrast used.

Other risks include: pelvic infection (rare; in a Taiwanese cohort of about 7,900 women it occurred in 0.46% of those given preventive antibiotics and 1.42% of those who were not), allergic reaction to the contrast dye (very rare), and a small dose of ionising radiation from the X-ray. The radiation dose from a single HSG is low. The procedure is not performed during pregnancy, which is why careful cycle timing is essential.

Spotting and light cramping for 24 to 48 hours after the test are normal and not a cause for concern. You should contact the clinic promptly if you develop a temperature above 38 degrees Celsius, heavy vaginal bleeding, severe or worsening pelvic pain, or an unusual vaginal discharge in the days following the procedure.

One of the most clinically interesting aspects of the hysterosalpingography test is that it may have a therapeutic effect beyond diagnosis. The flushing of the fallopian tubes with contrast dye is thought to clear minor mucus plugs, debris, or mild adhesions that could be impeding sperm or embryo transport. This is sometimes called the post-HSG fertility boost.

Research published in Frontiers in Endocrinology (2023) found, in a retrospective study of 413 women having IUI, that clinical pregnancy and live birth rates were higher when IUI was done within 6 months of an HSG. The live birth rate was 17.4% within 6 months and 8.1% when the interval exceeded 12 months, which suggests that any benefit may be time-limited. This finding has practical implications: if your HSG result is normal or shows only minor findings, your consultant may recommend proceeding with fertility treatment promptly rather than waiting.

The type of contrast medium also appears to matter. Oil-soluble contrast medium has been associated with higher post-procedure pregnancy rates in several studies, and a 2024 PubMed Central study found that baseline iodine deficiency correlated with improved pregnancy rates after OSCM HSG, pointing to a possible iodine-mediated mechanism. Your consultant will weigh the potential benefits of OSCM against the thyroid monitoring requirements when choosing the contrast type for your procedure.

The hysterosalpingography test is widely available in Chennai at fertility clinics, radiology centres, and hospital imaging departments. Costs vary depending on the facility, the type of contrast medium used, and whether the procedure is performed under fluoroscopy (real-time X-ray) or with a digital imaging system. As a general guide, HSG in Chennai typically ranges from a few hundred to a few thousand rupees, with the exact figure depending on the centre and the clinical protocol followed.

When comparing options, it is worth asking whether the procedure is performed by or in close collaboration with a fertility specialist rather than a general radiologist, since the interpretation of results in the context of your overall fertility evaluation is as important as the imaging itself. At Jananam Fertility Centre in Neelankarai, the hysterosalpingography test is integrated into a complete fertility workup, so findings are reviewed alongside your AMH, ultrasound, and semen analysis results in a single consultation rather than in isolation.

Jananam does not publish specific prices on its website in line with standard medical practice, but the team will provide a clear breakdown of costs during your initial consultation. There are no hidden fees, and the team will explain exactly what is included before you proceed.

Jananam Fertility Centre is a single-speciality fertility clinic in Neelankarai, Chennai, focused exclusively on the diagnosis and treatment of infertility. Because the clinic treats only fertility cases, the hysterosalpingography test is never an isolated procedure: it is part of a coordinated evaluation that includes ovarian reserve testing, semen analysis, and a detailed consultation to map out a personalised treatment plan.

The consultants at Jananam have over two decades of combined experience in reproductive medicine and are familiar with the full range of HSG findings and their implications, from straightforward tubal patency to complex uterine anomalies requiring hysteroscopic correction before IVF. For patients whose HSG reveals bilateral tubal blockage or hydrosalpinx, the team can discuss ICSI-based IVF or, where appropriate, donor egg IVF as the next step, all within the same clinic.

Jananam's Certified Cleanroom Laboratory is particularly relevant for patients who proceed to IVF after an abnormal HSG result, since the controlled environment minimises contamination risk during egg collection, fertilisation, and embryo culture. Patients with conditions such as endometriosis or unexplained infertility, where HSG findings may be normal despite ongoing fertility challenges, benefit from the clinic's ability to investigate further with pre-implantation genetic testing and advanced sperm assessment including sperm DNA fragmentation testing.

The team at Jananam understands that undergoing a hysterosalpingography test can feel daunting, and every patient receives a clear explanation of their results, written notes to take home, and a follow-up appointment to discuss next steps. You are never left to interpret a report alone.