The causes of female infertility, in addition to ovulatory disorders, can also include tubal factors, such as fallopian tube obstruction, or pelvic factors, such as endometriosis. Therefore, as part of our investigation, outside of a diagnostic laparoscopy, two types of MRI exams help us determine the precise nature of a tubal factor.
Female pelvic infertility - Hysterosalpingography
What is it?
The hysterosalpingography is an x-ray of the uterus and fallopian tubes. It consists in introducing a contrast medium trans-vaginally into the uterus and taking several x-ray images.
It starts off with a pelvic exam. But first, the vagina and cervix are cleansed with antiseptic soap. A contrast material is injected through a sterile system into the uterus after disinfection. Images are taken while the contrast material is slowly injected into the uterus and fallopian tubes.
Duration of exam
While the duration of the exam can vary based on your anatomy and number of images required, it typically takes about 10 minutes.
What are the risks?
Any procedure on the human body, even when performed in an environment of maximum competence and safety, carries the risk of complications.
The most common incidents encountered are:
- Pelvic pain, similar to menstrual cramps, that don’t last long and that are relieved by taking anti-inflammatories.
- Light bleeding for a day after the exam.
Extremely rare risks include:
- A pelvic infection in about 1 to 2% of cases.
- Allergic reactions to the iodized product.
Benefits and limits
This exam is justified by your health to localize and identify any condition you may have. This exam, like any x-ray exploration, is not 100% guaranteed. Lesions may not be detected by this x-ray technique. During the exam, everything will be done by the doctor to obtain the best diagnostic performance.
You may receive an initial comment right after the exam. This is an initial approach, as the images must then be analyzed by the radiologist. The written report will be available as soon as possible.
You should know that…
Certain elements in your medical history could mean we prescribe a premedication before the exam or delay the date of the exam or, though rarely, cancel the exam and replace it with another type of exploratory procedure.
To make an appointment
Generally, your appointment must be set within the first 12 days of your cycle, which is after menstruating and before ovulation. If in doubt, don’t hesitate to ask questions.
A preventive antibiotic treatment is generally prescribed an hour before the exam. If you have had a pelvic infection or a sexually transmitted illness in the past, discuss it with your attending physician.
We ask you to always perform a pregnancy test the day before the exam to ensure you are not pregnant. Also, recent screening for chlamydia and gonorrhea must be negative.
In order to reduce the abdominal cramps secondary to the hysterosalpingography, we also recommend you take anti-inflammatory medication, such as naproxen or ibuprofen, before the x-ray exam, if it’s not contraindicated and you are not allergic.
The hysterosalpingography is covered by RAMQ when it’s performed in a hospital setting. Several hospitals offer this radiology service: Centre hospitalier régional de Lanaudière (450) 759-8222 ext. 2845, Hôpital Maisonneuve-Rosemont (514) 252-3581, Hôpital Pierre Boucher (450) 468-8111 ext. 1, and CHUM (pavillon St-Luc) (514) 890-8309.
A similar exam, the hysterosalpingosonography, may be performed in a private setting, at FERTILYS Centre, located at 1950 Maurice Gauvin Street, Suite 103, in Laval, by contacting us directly at (450) 934-9146. This ultrasound exam, however, is not covered by RAMQ. It’s sometimes covered by private insurance plans.