One of the causes of female infertility is tubal factor, such as fallopian tube obstruction. Therefore, as part of our investigation, outside of a diagnostic laparoscopy, two types of radiological exams help us evaluate the fallopian tubes.

Hysterosalpingography (HSG)

Classical hysterosalpingography (HSG) is an X-ray exam that uses a radiopaque contrast (solution) to determine the patency of the fallopian tubes. This procedure, done under fluoroscopy, uses X-rays and is therefore only carried out in radiology centers or in hospitals.

It is not offered at Fertilys.

Hysterosalpingosonography (HSSG)

For many years now, HSG has been largely replaced by hysterosalpingosonography (HSSG), performed by ultrasound. The radiopaque solution is simply replaced by the instillation of saline water. It is this medical imaging technique that we offer at Fertilys. It is as sensitive and specific as HSG in confirming fallopian tube patency.

The benefits of hysterosalpingosonography

Compared to HSG, HSSG has several advantages:

  1. It does not expose patients to X-rays;
  2. Since it is performed by vaginal ultrasound, it allows a more global view of the uterus and ovaries, including evaluation of ovarian reserve and the uterine cavity in 3D.

Examination procedure

A gynecologist performs this procedure. First, the cervix is cleansed with antiseptic solution. The instillation of saline is carried out using a sterile catheter inserted in the cervix after disinfection. Ultrasound images are recorded during the slow instillation of saline water 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 10-15 minutes.

What are the risks?

Any procedure performed on the human body, even when performed in an environment of maximum competence and safety, carries the risk of complications.

The most common situations encountered are:

  • Pelvic pain, like menstrual cramps, that does not last long and that is relieved by taking anti-inflammatory medications.
  • Light bleeding for a day after the exam.

Rare risk include:

  • A pelvic infection in about 1 to 2% of cases.


This exam, like any radiological examinations, is not 100% accurate. Sometimes due to technical difficulties, we may not be able to visualize all the gynecological organs completely or even complete the exam. The gynecologists will do their best to complete this procedure.


The gynecologist performing the exam will tell you the result right after the exam. The gynecologist will also inform you if additional investigations are needed due to the results of the exam.

To make an appointment

Generally, your appointment must be scheduled within the first 12 days of your cycle, which is after menstruation and before ovulation. If in doubt, don’t hesitate to ask questions.

A preventive antibiotic treatment is prescribed and to be taken an hour before the exam. If you have had a pelvic infection or a sexually transmitted illness in the past, discuss it with your treating physician.

We ask you to perform a pregnancy test the day before the exam to ensure you are not pregnant. Also, a recent negative test result for chlamydia and gonorrhea is required.

We recommend taking anti-inflammatory medication, such as naproxen or ibuprofen, before the exam to reduce abdominal cramps, if it’s not contraindicated and you are not allergic.

HSSG is offered at both Fertilys clinics, located in Laval at 1950 rue Maurice Gauvin and in Brossard at 2000 R. de l'Éclipse, by contacting us directly at (450) 934-9146 ( Laval) or at (450) 550-9146 (Brossard). This exam is not covered by RAMQ. It’s sometimes covered by private insurance plans.