Understanding Your HSG Report

A plain-language guide to hysterosalpingography (HSG) — what the procedure involves, how to read your results, and what comes next.

What is an HSG?

A hysterosalpingogram (HSG) is an X-ray procedure in which a small amount of radio-opaque dye is injected through the cervix into the uterus and fallopian tubes. It is the standard test to check whether your fallopian tubes are open (patent) and your uterine cavity is normal.

What to Expect

Performed on Days 6–10 of your menstrual cycle (before ovulation)
Takes 15–30 minutes, performed by a radiologist
Mild to moderate cramping during and immediately after the procedure (similar to a strong period pain)
Take ibuprofen 1 hour before if not contraindicated
You can resume normal activities the same day

Reading Your HSG Report

Normal uterine cavity: Triangular shape, smooth outline — no filling defects
Filling defect: May indicate polyp, fibroid, septum, or Asherman adhesion — further assessment with hysteroscopy recommended
Bilateral tubal patency (spill): Dye spills freely from both tube ends — tubes are open ✅
Proximal block: Dye does not enter tube from uterus — may be spasm (repeat) or true blockage
Distal block / hydrosalpinx: Dye fills tube but does not spill — tube blocked at fimbrial end
Unicornuate / bicornuate / septate pattern: Uterine anomaly — MRI for characterisation recommended

After the HSG

Light spotting for 1–2 days is normal
Avoid unprotected intercourse until the period after HSG (infection precaution)
HSG has a small therapeutic effect — some studies show slightly higher pregnancy rates in the month after a normal HSG
If a problem is found: your doctor will discuss the next steps (hysteroscopy, laparoscopy, or IVF)