Hysterosalpingogram (HSG) in Las Vegas: What to Expect

After reviewing your medical history and initial blood work, the next step in your fertility evaluation is often a structural assessment. At The Fertility Center of Las Vegas, our specialists typically perform a HyFoSy or HyCoSy for tubal evaluation — advanced in-office ultrasound procedures that are comfortable and don’t require radiation.

In some cases, however, your doctor may recommend a hysterosalpingogram (HSG) — an X-ray-based tubal evaluation performed at a radiology center. This may be the case if you’ve already had an HSG performed elsewhere, or if your specific clinical situation makes it the most appropriate option. This page explains what an HSG is, when it’s used, and exactly what to expect if one is recommended for you.

When is an HSG recommended?

An HSG is not part of FCLV’s standard tubal evaluation protocol — we primarily use in-office HyFoSy or HyCoSy for most patients. However, your doctor may recommend or order an HSG in the following situations:

• You have an existing HSG: if you had an HSG performed at another facility prior to coming to FCLV, your doctor may use those results as part of your diagnostic work-up.
• Suspected tubal blockage: particularly in patients with a history of pelvic inflammatory disease (PID), history of chlamydia infection, severe endometriosis, previous abdominal surgeries, or previous ectopic pregnancies.
• Evaluation of uterine abnormalities: to identify polyps, submucosal fibroids, adhesions (Asherman’s syndrome), or structural irregularities that could interfere with implantation.
• Recurrent pregnancy loss: to rule out uterine shape or structure as a contributing factor in repeated miscarriages.
• Verification after tubal surgery: to confirm the success of a tubal ligation reversal or the removal of a blockage.

What does an HSG show?

Blocked fallopian tubes and uterine abnormalities are among the most common causes of female infertility. An HSG is an X-ray procedure that gives your doctor a clear picture of two key things:

• Uterine shape and cavity: an abnormal uterine shape, adhesions, or the presence of polyps can interfere with embryo implantation and increase the risk of pregnancy loss.
• Fallopian tube patency: if there is a blockage in one or both fallopian tubes, sperm cannot reach the egg. Identifying this early allows us to plan the most effective treatment.

If your doctor identifies either issue, there are highly effective treatments available. In cases of severe bilateral tubal blockage, In Vitro Fertilization (IVF) is typically recommended — it allows fertilization to happen in the laboratory, bypassing the fallopian tubes entirely.

What happens during a Hysterosalpingogram procedure?

Because an HSG is performed at a radiology center — not at our FCLV office — your doctor will provide a referral and coordinate the scheduling. To ensure accuracy and your comfort, the procedure is typically scheduled between day 7 and day 10 of your menstrual cycle. You’ll be asked to avoid sexual intercourse in the days leading up to the procedure, and you may need to have a pregnancy test before scheduling or performing the procedure. You will also need to have a driver accompany you to the test.

On the day of your HSG, you’ll lie on an exam table with your feet in stirrups. Here’s what the procedure involves:

1. A thin tube (catheter) is gently inserted through the vagina and cervix into the uterus.
2. A special iodine-containing contrast dye is injected through the catheter. A radiologist takes X-ray images as the dye flows through the uterine cavity and into the fallopian tubes. The dye shows up in a contrasting color on the X-ray, making the uterine cavity and any abnormalities clearly visible.
3. If the fallopian tubes are open, the dye will fill them and spill out into the pelvic cavity, where the body reabsorbs it naturally. If a tube is blocked, the dye will not flow through.

It’s common to experience cramping during the procedure, particularly when the dye is injected. To help minimize discomfort, we recommend taking a preventive dose of an NSAID (such as ibuprofen) before your appointment at the radiology center.

After the procedure, it’s normal to notice some light vaginal discharge as your body expels the remaining contrast dye. Wearing a pad or panty liner for a few hours afterward is a good idea.

What are the next steps after an HSG?

The radiology center will send your results to our office, typically within approximately three business days. Once all diagnostic testing is completed, you’ll schedule a follow-up visit with your FCLV doctor to review the findings and discuss next steps and treatment recommendations.

Questions about your HSG? We’re here to help

If you’ve been referred for an HSG or have questions about what your results mean, our team is here to walk you through every step. Contact our Las Vegas fertility clinic and let’s talk through your next steps together.