The likelihood of pregnancy after undergoing a hysterosalpingogram (HSG) can be influenced by the underlying cause of infertility. In certain cases, a study has shown that using an oil-based contrast during an HSG significantly improves pregnancy rates. This is also associated with a higher rate of subsequent live births.

An HSG is a specialized x-ray procedure where an iodine dye is administered through the cervix into the uterus and fallopian tubes, followed by x-ray imaging. The primary purpose of this test is to assess the general shape of the uterus and determine if the fallopian tubes are clear.

Many women share experiences on fertility forums claiming successful pregnancies within a few months of undergoing an HSG. Some doctors may even inform patients that they have an increased likelihood of conceiving after this fertility assessment. However, the probability of getting pregnant after an HSG varies depending on individual factors.

Factors affecting the chance of pregnancy after an HSG:

1. Reasons behind initial difficulty in conceiving:

  • The likelihood of pregnancy following an HSG depends on the underlying cause of infertility.
  • The HSG may be more effective in certain cases where the cause of infertility is compatible with the benefits of the procedure.

2. Type of contrast medium used:

  • The type of contrast medium used during the HSG procedure can influence the potential for increased pregnancy rates.
  • Studies have shown that an HSG with an oil-based contrast medium may offer a greater boost in pregnancy rates compared to water-based contrast media.
  • It is advisable to discuss with your doctor about the type of contrast medium they plan to use during the HSG.

3. Diagnostic purpose of HSG:

  • It’s important to understand that doctors primarily order an HSG for diagnostic purposes.
  • The main goal is to assess the shape of the uterus and the patency of the fallopian tubes.
  • The HSG is not typically employed as a standalone treatment for infertility.

4. Limited timeframe for increased pregnancy chances:

  • In some cases, the mere placement of the catheter into the cervical OS during the HSG procedure may enhance pregnancy rates.
  • The duration of increased odds may vary from person to person.

It’s crucial to consult with your healthcare provider to determine the specific factors relevant to your situation and discuss the expectations and potential outcomes associated with an HSG procedure.

HSG Increases Pregnancy Success

HSG procedures involve introducing a water-based or oil-based contrast medium into the uterus and fallopian tubes. This fluid contains a dye that allows visualization of the uterine shape and fallopian tubes on an x-ray screen. In addition to its diagnostic use, the contrast medium can also be therapeutically utilized for “tubal flushing” without imaging.

Research comparing the effectiveness of tubal flushing with different contrast media (oil-based, water-based, combination, or no tubal flushing) in women with infertility has shown increased pregnancy rates over a six-month period with both oil-based and water-based contrast media. However, a greater increase in pregnancy rates was observed among those who received oil-based contrast medium. This effect remained consistent regardless of the couples’ varied characteristics.

If you are seeking the potential pregnancy boost, it is advisable to opt for an HSG procedure using oil-based contrast. You can discuss this option with your doctor to ensure they plan to use the appropriate contrast medium.

Chances of Pregnancy After HSG

Analyzing 13 randomized controlled trials, one study found that among subfertility women with a 17% chance of conceiving in any given month without intervention, undergoing tubal flushing with an oil-soluble contrast medium during an HSG increased the rate to between 29% and 55%.

This improvement in pregnancy odds persisted for up to three months following the procedure.

Why Does HSG Increase Pregnancy Success?

Reasons behind increased pregnancy success after an HSG or tubal flushing:

  • The exact reasons are not fully understood.
  • Researchers have proposed several theories to elucidate this phenomenon.
  • Theories explain about increased pregnancy success:

1. Clearing minor blockages in the fallopian tubes:

  • The dye solution used in the HSG may help clear minor blockages in the fallopian tubes.
  • It is important to note that the procedure cannot address severe blockages.
  • X-ray images may show unblocked fallopian tubes, even if the contrast appears to pause and then continue.
  • This suggests that the dye may break through thin adhesions.

2. Enhancement of the endometrium:

  •  The dye solution may enhance the endometrium, the lining of the uterus.
  • This enhanced environment may make it more receptive for successful embryo implantation.
  • Researchers speculate that the dye solution in the HSG may have an anti-inflammatory effect, which could actively support the process of implantation.

3. Impact on the ovarian area:

  • Another theory suggests that the dye solution used in the HSG may have an impact on the area surrounding the ovaries.
  • This impact could potentially enhance ovulation, increasing the chances of pregnancy.

4. Placement of the catheter and endometrial scratching:

  • In certain cases, inserting the catheter into the cervical os during the HSG procedure may improve pregnancy rates.
  • When performed therapeutically, medical professionals refer to this process as endometrial scratching.
  • However, it’s important to note that endometrial scratching can be painful, expensive, and may have side effects.

It’s important to note that researchers have not fully determined the exact mechanisms behind the increased pregnancy success after an HSG, despite the existence of these theories. Researchers need to conduct further studies to gain a better understanding of these processes.

Individuals with unexplained infertility, possible immunological fertility problems, and early-stage endometriosis appear to experience a more significant impact from tubal flushing.

Approaching the HSG procedure with realistic expectations is crucial. Considering it as a fertility assessment rather than a definitive treatment will help manage potential disappointment if conception does not occur in the immediate months following the procedure. It is important to view pregnancy subsequent to an HSG as a possible bonus rather than the primary goal.

FAQ About Pregnancy After HSG

Q: Can an HSG address severe blockages?

A: No, an HSG cannot address severe blockages in the fallopian tubes. Severe blockages may require other forms of treatment.

Q: Is pregnancy guaranteed after an HSG?

A: Pregnancy is not guaranteed after an HSG. While the procedure may increase the chances of pregnancy, it depends on the individual’s underlying fertility issues and other factors.

Q: How long does the increased chances of pregnancy last after an HSG?

A: Studies have shown that the increased odds of pregnancy can last for up to three months after the HSG procedure.

Q: Is an HSG performed as a treatment for infertility?

A: No, an HSG is primarily used as a diagnostic procedure to assess fertility issues.

Q: Is it recommended to consider pregnancy as the primary goal after an HSG?

A: It is advisable to view pregnancy subsequent to an HSG as a possible bonus rather than the primary goal. The primary purpose of the HSG is to diagnose and assess fertility issues.

Also read : The HSG Test : Understanding Procedure And Purpose

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