Female infertility testing is a group of examinations that look for the reason a pregnancy has not occurred. It usually includes hysterosalpingography (HSG), pelvic ultrasound and hormone blood tests. The aim is to identify the cause of infertility and plan suitable treatment by assessing the fallopian tubes, uterus, ovaries and ovulation.
During HSG the doctor passes a thin tube through the cervix, injects contrast dye and takes X-ray images that show the uterine cavity and whether the tubes are open. This is complemented by transvaginal or abdominal ultrasound, hormone tests on specific days of the cycle and, sometimes, hysteroscopy. These tests are mostly non-surgical and do not require general anaesthesia.
HSG takes about 10 to 30 minutes and is usually scheduled after the period ends and before ovulation. Most women return to normal activity the same day. Results are usually available the same day or within a few days, and the doctor explains them and decides the next step.
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They can reveal causes such as blocked fallopian tubes, uterine abnormalities, fibroids, ovulation problems and hormonal imbalance, which helps the doctor choose suitable treatment.
Couples who have not conceived after about a year of regular unprotected intercourse, or after six months if the woman is over 35, or when a cause is already suspected. The partner is also usually checked with a semen analysis.
HSG is scheduled after the period ends and before ovulation so that it is not done during a possible pregnancy. A painkiller may be advised beforehand, and an antibiotic in some cases. Tell the doctor about any allergy, especially to contrast dye or iodine, and about all your medicines, and never stop a prescribed drug on your own.
You lie on the X-ray table while the doctor passes a thin tube through the cervix, then injects the dye gradually and takes images. They show the shape of the uterus and whether the dye passes through the tubes. You may feel cramps similar to period pain.
They include pelvic ultrasound, hormone tests such as FSH and prolactin, ovarian reserve assessment, thyroid tests and, sometimes, hysteroscopy. The doctor selects what your situation requires.
Most women resume normal activity the same day. Mild cramps, dye-stained discharge or light spotting may last a day or two.
The HSG result is usually available the same day or within a few days, as are hormone tests. Based on them, the doctor may suggest continuing to try naturally, treating an ovulation disorder, surgery, or assisted reproduction.
Pain and cramps are common and usually mild. Rarely, a pelvic infection, an allergic reaction to the dye or light bleeding can occur. The test involves a low radiation dose and is not performed during pregnancy or an active pelvic infection.
They usually leave no scars because HSG is done through the vagina without any incision. Some women may find their chances of conception improve briefly afterwards, but this cannot be relied upon.
One or two days are often enough for the imaging and its results, although the stay may be longer if other tests are needed on specific days of the cycle. The treating doctor confirms the plan.
