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Hysterosonogram (HSN)
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To achieve pregnancy, whether by intercourse or insemination, there must be passage through at least one of your fallopian tubes. If there is no passage, the egg and sperm cannot meet, and fertilisation of the egg cannot take place.
If there is reduced passage in the fallopian tube, there will be an increased risk of an ectopic pregnancy. Therefore, we recommend that you have your fallopian tubes checked for passage by an ultrasound scan with passage study called a hysterosonogram (HSN).
HSN is a prerequisite if you want hormone-stimulated insemination. If both your fallopian tubes are closed, the only option for achieving pregnancy is IVF treatment.
Passage in fallopian tubes with HSN
Most women have normal passage through the fallopian tubes, but if you have a history of pelvic inflammatory disease, chlamydia, appendicitis, endometriosis or other conditions where damage to your fallopian tubes is suspected, there is an increased risk of impaired passage or blocked fallopian tubes. An asymptomatic pelvic inflammatory disease ("mute infection") with chlamydia can also occur and cause narrowing or blockage of your fallopian tubes.
You can have an HSN examination here at the clinic to find out whether you have normal passage through your fallopian tubes. In hospitals and X-ray clinics, a study can be done using contrast media with simultaneous X-ray imaging. The test is called a hysterosalpingography (HSG).
How the HSN is done
The examination is carried out between the 7th and 12th day of the cycle, after menstruation has stopped and before the expected time of ovulation. We do not inseminate in the same cycle as the HSN. A negative chlamydia test, which must be no more than 3 months old, is required before the examination can be carried out.
The HSN itself takes place in a gynaecological bed. After washing your cervix (to prevent bacteria from entering the uterine cavity), a thin catheter and a scanner are inserted. During the scan, a fluid is injected into the uterus, and the technician will follow the fluid's passage through the fallopian tubes. If the fallopian tubes are closed, the fluid cannot flow freely.
Some people experience menstrual-like pain during the scan. The HSN is done without anaesthetic, and the vast majority can go to work immediately after the examination. For some, it may be a good idea to take some painkillers an hour before an HSN. There will be an opportunity for you to rest before you go home again.
After the HSN, there may be some extra thin discharge and perhaps some spotting. We recommend that you use a sanitary towel afterwards. There is minimal risk of infection, but should you develop pain and fever in the days following the examination, it is important that you contact a doctor for possible treatment. You can take Panodil as a painkiller, but this is not usually necessary. If normal passage of both your fallopian tubes cannot be detected, our doctor will inform you about further steps. You may be advised to undergo a laparoscopic examination of the fallopian tubes or to proceed directly to IVF treatment.
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