What is a Hysterosalpingogram (HSG) and How is it Used During an Infertility Evaluation?
Dr. Marika Raff • January 28, 2025
When couples or individuals begin their fertility journey, one of the first and most important steps is a thorough evaluation to identify the underlying causes of infertility. At Caperton Fertility Institute, we use several advanced diagnostic tools to assess reproductive health. One such tool is the hysterosalpingogram (HSG), a specialized test that provides critical information about the health of the uterus and fallopian tubes.
If your fertility care team has recommended an HSG, or if you’re curious about how it fits into the fertility evaluation process, here’s everything you need to know about this procedure and its role in helping you achieve your dream of parenthood.
If your fertility care team has recommended an HSG, or if you’re curious about how it fits into the fertility evaluation process, here’s everything you need to know about this procedure and its role in helping you achieve your dream of parenthood.
When is an HSG Recommended?
An HSG is typically performed as part of the initial fertility evaluation for individuals or couples who are having difficulty conceiving. It’s especially useful if:
- You’ve been trying to conceive for over 12 months (or 6 months if you’re over 35).
- You’ve had a history of pelvic infections, endometriosis, or abdominal surgery, which may increase the risk of tubal blockages or adhesions.
- You’ve experienced recurrent miscarriages.
- Your care team needs to confirm that your uterus and fallopian tubes are healthy before starting treatments like intrauterine insemination (IUI) or in vitro fertilization (IVF).
What Can an HSG Reveal?
The HSG provides valuable information about two critical components of female fertility:
1. Uterine Abnormalities
The shape and structure of the uterus are essential for successful implantation and pregnancy. An HSG can reveal:
- Fibroids or Polyps: Growths that may distort the uterine cavity.
- Congenital Uterine Abnormalities: Conditions like a uterine septum or bicornuate uterus, which can interfere with pregnancy.
- Scar Tissue (Adhesions): Adhesions inside the uterus (Asherman’s syndrome) that can result from infection or surgery.
2. Fallopian Tube Blockages
Open fallopian tubes are essential for natural conception, as they allow the egg and sperm to meet. An HSG can detect:
- Blocked Tubes: A blockage in one or both fallopian tubes can prevent fertilization.
- Hydrosalpinx: A condition in which fluid builds up in the fallopian tubes, potentially impacting fertility and the success of IVF.
- Tubal Damage: Scarring or irregularities in the tubes caused by infections, endometriosis, or prior surgeries.
Partnering with Caperton Fertility Institute
At Caperton Fertility Institute, we’re committed to providing the highest standard of care for individuals and couples navigating infertility. The hysterosalpingogram is just one of the many diagnostic tools we use to create a personalized treatment plan tailored to your unique needs.
Whether you’re just beginning your fertility journey or seeking answers to long-standing questions, our expert team is here to support you every step of the way. From diagnosis to treatment, we’ll help you take the next step toward achieving your dream of parenthood.
If you’re ready to start your fertility evaluation or have questions about the HSG procedure, we recommend consulting trusted resources for more information, such as:
- Fertility and Sterility – Published by the American Society for Reproductive Medicine (ASRM).
- Human Reproduction – A leading journal in reproductive medicine.
- The Journal of Obstetrics and Gynecology – Offers reviews on gynecologic imaging techniques.
- Radiographics – Focuses on imaging techniques, including HSG.
- UpToDate – A trusted clinical resource for healthcare providers.
What Is a Semen Analysis? A semen analysis evaluates the health and viability of a man's sperm. This non-invasive test measures multiple parameters that are crucial for successful conception: Volume The amount of ejaculate, with a typical normal range between 1.5 to 5 milliliters. Sperm Concentration The number of sperm per milliliter of semen. A normal sperm count is 15 million/mL or higher. Motility The percentage of sperm that are actively moving. A minimum of 40% motility is generally considered normal. Morphology The size and shape of sperm, assessed using strict criteria. A morphology score of 4% or more normal-shaped sperm is acceptable. pH Level Measures the acidity or alkalinity of semen, with a normal range from 7.2 to 8.0. White Blood Cells Elevated levels may signal infection or inflammation in the reproductive tract. Liquefaction Time Refers to how long it takes semen to liquefy after ejaculation. Normal liquefaction occurs within 20 to 30 minutes. What Do Abnormal Semen Analysis Results Mean? An abnormal result doesn’t automatically mean infertility. Semen quality can vary over time, so further testing is often needed to understand the full picture. Depending on the results, your provider may recommend: Repeat Semen Analysis: To confirm initial findings. Hormonal Testing: Evaluates hormone levels like testosterone, FSH, LH, and prolactin. Genetic Testing: For severely low sperm counts or azoospermia, this can reveal chromosomal abnormalities or Y chromosome deletions. Scrotal Ultrasound: Detects physical issues such as varicoceles or obstructions. Referral to a Urologist: For evaluation and management of urological or endocrine disorders. Tailored Treatment for Male Factor Infertility At Caperton Fertility Institute, we take a holistic and individualized approach to male infertility. Based on your specific diagnosis, treatment options may include: Lifestyle changes to improve sperm health Medical therapies to balance hormones or treat infections Intrauterine insemination (IUI) In vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI) Schedule a Fertility Consultation Today If you or your partner are considering fertility testing, our experienced team in Albuquerque and El Paso is here to support your journey. Schedule your consultation today to take the first step toward growing your family. Tags: Semen Analysis, Male Fertility, Sperm Count, Infertility Testing, Caperton Fertility Institute, Albuquerque Fertility, El Paso Fertility, IVF, ICSI, Male Factor Infertility
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