What should you know about HSG and hydrosalpinx?

An hysterosalpingogram, or HSG, uses contrast fluid and X-rays to assess the uterine cavity and whether contrast passes through the fallopian tubes. Hydrosalpinx means a tube has become widened and filled with fluid, often after inflammation, infection, previous pelvic surgery or endometriosis. Pelvic inflammatory disease is one possible cause. The report may describe delayed spill, a dilated tube or fluid collecting near the tube; these phrases need interpretation alongside your symptoms and history.

A hydrosalpinx can affect the movement of an egg and sperm and may influence fertility treatment planning. One tube can be affected or both can be involved. An HSG finding is not, by itself, a complete fertility assessment.

Arrange a follow-up with your gynaecologist or fertility clinician to review the images and report. They may discuss ultrasound, other imaging, infection testing or an operation, depending on your goals and findings. Treatment choices can include removing or treating the affected tube, while IVF may be discussed when pregnancy is desired. Do not start antibiotics or fertility medicines without an assessment.

Contact your care team promptly for fever, worsening pelvic pain, faintness, vomiting, heavy vaginal bleeding or feeling acutely unwell after an HSG. These symptoms can signal a complication or infection and should not be judged by the HSG result alone. Seek emergency help for severe pain, collapse or difficulty breathing.

Ask whether the HSG shows one tube or both, whether contrast entered the abdomen, and whether the appearance could reflect spasm. Ask what further assessment is useful, how the finding affects your fertility plan, and whether Salpingectomy or IVF is relevant to your situation.