Why Do I Need an HSG or SIS Test?

If you’re having trouble conceiving, your doctor might suggest you take some tests to evaluate your fallopian tubes and uterus. The fallopian tubes are critical for pregnancy to occur since this is where fertilization takes place. The test used to evaluate the fallopian tubes is called a hysterosalpingogram (HSG), which is an x-ray test. A contrast is slowly injected into the uterus while taking images. This test can tell us if your fallopian tubes are open or blocked or if there are any abnormalities.

The uterine cavity is the site where implantation occurs and the baby begins to grow. Therefore, it is good to evaluate the uterus for any abnormalities. We can see the uterine cavity during the HSG procedure and if there are any suspicions for an abnormality, another uterine evaluation test is often recommended. An office hysteroscopy (OH) or saline sonohysterogram (SIS) are procedures that look at the uterine cavity. Saline (like water) is infused into the uterus to visualize the uterine cavity with either with a small camera or ultrasound. These tests are typically done between days 5-12 of your menstrual cycle (when your period is over but before ovulation).

I have had these procedures and they do cause your uterus to cramp, like a bad menstrual period. If you don’t have any allergies, I recommend taking a nonsteroidal anti-inflammatory (NSAID) medication such as Advil or Ibuprofen at least 1 hour prior to your procedure.

Here’s a look at a normal hysterosalpingogram (HSG) image showing the uterus and spill of dye into the pelvis.

This is a saline sonohysterogram (SIS) in which a polyp was found in the uterine cavity.