A hysterosalpingogram is an xray examination in which contrast medium is introduced into the womb which shows up on xray and will show an absence of contrast medium or a filling defect in areas of the cavity which are obstructed by adhesions. It does not require an anaesthetic and is usually not unduly painful as long as the doctor performing the procedure does not use too much pressure. A speculum must be used so that the cervix (neck of the womb) can be seen and a small plastic tube about 2mm in diameter is introduced into the cervix, rather like having a smear test for cervical cancer. A tiny balloon is inflated to keep it in place and then xray contrast medium is gently instilled whilst xray images are taken. The whole procedure should only take about 15 minutes. There is no need to fast prior to the procedure.

Sometimes the cervical canal is difficult to cannulate or may be acutely retroverted, in which case te doctor may need to use a small clip called a tenaculum to stabilise or straighten out the cervical canal. This may cause further pain, like a period pain or cramp.

The image below shows the normal outline of the uterus and Fallopian tubes This image shows isolated adhesions within the cavity.

This image shows the cervical canal is completely obstructed and contrast medium fails to enter the cavity at all