Hysterosalpingogram (HSG): Checking Your Fallopian Tubes and Uterus

What Is an HSG?

A hysterosalpingogram, usually called an HSG, is an X-ray procedure used to look at the inside of the uterus and check whether the fallopian tubes are open. It is one of the most common tests used during a fertility evaluation, since blocked tubes and structural issues inside the uterus are a leading contributor to difficulty conceiving.

At Kofinas Fertility Group, the HSG is often one of the first diagnostic steps we recommend, because it gives clear, direct information about two structures essential to natural conception.

Why an HSG Is Performed

Your provider may recommend an HSG to:

• Check whether one or both fallopian tubes are open, since a blocked tube can prevent sperm from reaching an egg or prevent a fertilized egg from reaching the uterus
• Look for scarring or structural abnormalities in the uterus that may contribute to infertility or repeated pregnancy loss
• Identify polyps, fibroids, or adhesions inside the uterine cavity
• Confirm whether a prior tubal reversal was successful

What to Expect During the Procedure

An HSG is typically performed in an outpatient setting and takes less than five minutes to complete, though you should plan for some time before and after. Here is generally what happens:

1. You will be positioned on an exam table, similar to a routine pelvic exam.
2. A speculum is placed, and the cervix is cleaned.
3. A thin tube (cannula) is inserted into the cervical opening.
4. A contrast dye is gently released through the cannula, filling the uterus and flowing into the fallopian tubes.
5. X-ray images are taken as the dye moves, allowing your care team to see the shape of the uterus and whether the dye spills freely from the tubes.

The HSG is usually scheduled after your period ends but before ovulation, which helps avoid interference from a possible early pregnancy and allows for clearer images.

What You Might Feel

Many patients experience mild to moderate cramping during and shortly after the procedure, usually lasting around 5 to 10 minutes, though some notice cramping for a few hours. Taking an over-the-counter pain reliever beforehand, as recommended by your provider, may help.

After Your HSG

Most patients return to normal activities the same day. Some providers recommend avoiding intercourse for a few days following the procedure. Your care team will review your results and discuss next steps, which may range from reassurance that your tubes and uterus appear normal, to a referral for further evaluation or treatment if a blockage or structural issue is found.

About This Page

Meet George D. Kofinas, MD, FACOG

As the compassionate leader of Kofinas Fertility Group and a distinguished authority on fertility medicine, Dr. Kofinas has used his depth of knowledge and sharp intuition to help thousands of couples start families of their own. Dr. Kofinas has written and spoken about the full...

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By: George D. Kofinas, MD, FACOG
Reviewed By: George D. Kofinas, MD, FACOG

Published: Nov 10th, 2026

Last Reviewed: Nov 10th, 2026