HSG test in Goa: the tube test for women, explained

What is an HSG test?

HSG stands for hysterosalpingography. "Hystero" means the womb and "salpingo" means the fallopian tubes, so it is an X-ray test of the inside of the womb and the tubes. A thin, soft tube is placed in the neck of the womb (the cervix), and a small amount of special dye is passed gently through it. The dye fills the womb and, if the tubes are open, flows along them and spills out at their far ends. The X-ray pictures show the path the dye takes.

Many couples simply call it the tube test. You may also see it written as a blocked fallopian tubes test, a tubal patency test, or a tube test for women.

Why are the tubes tested at all?

Each month an egg is released from an ovary and picked up by a fallopian tube. The sperm meet the egg inside the tube, and the early embryo then travels along it to the womb. So a woman can ovulate every month and her husband can have a normal semen report, and still not conceive if both tubes are blocked.

Tubal blockage is often silent. It does not usually cause pain or other symptoms on its own, which is why it is tested for rather than assumed absent. Past pelvic infection, earlier surgery in the pelvis or endometriosis can leave the tubes blocked or scarred. Read more about the causes of female infertility and how they are tested.

The tube test also decides which treatment can work. IUI places the sperm in the womb, but the egg and sperm still have to meet inside a tube, so IUI needs at least one open tube. That is why the tube test is one of the tests a couple needs before IUI.

Who is the tube test for?

• Couples who have been trying for a baby and are starting their fertility tests.
• A woman who is about to start IUI, if her tubes have not been checked.
• A woman who has had a pelvic infection, earlier surgery in the tummy or pelvis, or endometriosis.
• A couple whose IUI cycles have not worked, if the tubes were not checked before.

Not every couple needs it at the same point. The doctor decides when the test is useful, from your history and your first tests. If IVF is already planned for another reason, the tube test may not change the plan, although a tube that is swollen with fluid can still matter, as explained below.

When in the cycle is the HSG done?

The HSG is done after your period has stopped and before ovulation, usually a few days after the bleeding ends. There are two reasons. The lining of the womb is thin at that time, so the picture is clear. And it makes sure that an early pregnancy cannot be disturbed by the test.

So, tell us on WhatsApp or by phone on the day your period starts, so that the test day can be booked. Avoid unprotected intercourse from the start of that period until the test. If your period is late, or there is any chance you could be pregnant, tell the team before the test.

How is an HSG done?

Consultations are held in Panjim, Margao, Mapusa and Vasco; the doctor tells you where and when the HSG is booked.

1. Before the test. The doctor goes through your history and your period dates, and tells you whether to take any medicine beforehand.
2. Lying down. You lie on your back, as for a routine internal examination, and a speculum is placed so that the cervix can be seen.
3. The dye. A thin, soft tube is passed into the cervix, and the dye is passed gently through it while the X-ray pictures are taken.
4. Going home. The test itself takes a few minutes and usually needs no anaesthesia. After a short rest, you go home the same day.

Does an HSG hurt?

Most women feel cramps like period pain while the dye passes, easing within a short while afterwards. Breathing slowly and keeping the tummy relaxed helps, and you can ask what is happening at each step, so nothing comes as a surprise.

What can the HSG show?

• Open tubes. The dye flows along both tubes and spills out at their ends.
• A blocked tube. The dye stops partway along the tube, or does not enter it at all. One open tube is enough for IUI.
• A hydrosalpinx. A tube that is blocked at its far end can fill with fluid and swell. On the HSG it shows as a widened tube with the dye collecting inside it.
• The shape of the womb. The dye outlines the inside of the womb, so something in the cavity, such as a polyp, a fibroid bulging into the cavity, a septum or adhesions, can show up. If it does, a hysteroscopy may be discussed.

A tube can sometimes look blocked on an HSG when it is only in spasm, a brief tightening of its muscle. So an unexpected result is read together with your whole history, and is sometimes confirmed in another way before a big decision is made.

What should you do after the test?

You can go back to normal daily life, and most women return to work the same day or the next. A sticky discharge as the dye comes out, and light spotting for a day or two, are common. Take any medicine exactly as the doctor advises. Call the hospital if you get a fever, pain that is getting worse instead of better, heavy bleeding or a bad-smelling discharge: an infection after an HSG is uncommon, but it needs prompt treatment.

What happens next: IUI or IVF?

The doctor goes through the result with you both, together with the semen report and your ovulation tests.

• At least one tube open. If the semen report is reasonable and ovulation can be helped, IUI is usually the first treatment to discuss. Read about IUI treatment in Goa, step by step.
• Both tubes blocked. IUI cannot work. In IVF, the eggs are collected directly from the ovaries and the embryo is placed in the womb, so the tubes are no longer needed. Read about our IVF centre in Goa.
• A hydrosalpinx. The swollen tube may need to be treated before IVF, often by keyhole surgery. Read about laparoscopic (keyhole) surgery.

Are there other ways to check the tubes?

Yes. Sono-salpingography is a similar test that uses fluid and an ultrasound scan instead of an X-ray. Laparoscopy is a keyhole operation under anaesthesia, chosen when there are other reasons to look inside, such as suspected endometriosis or a past pelvic infection; during it, dye is passed through the tubes and they are seen directly. The doctor suggests the test that suits your history.

What does an HSG cost?

The fee for the HSG is explained at the consultation, before the test is booked, together with any other tests you need. The fees for IUI and IVF are on the fertility fee list, fee by fee.

Getting started

Call or WhatsApp us and send any reports you already have, including an earlier HSG, so that a recent result is not repeated without need. This guide is by the Pai Hospital Team.

Your questions

Or call +91 95185 02773

This page is for general education and is not personal medical advice. Treatment depends on your own examination and reports, so please speak to a doctor about your situation. We do not carry out or offer sex determination of any kind.