Hysterosalpingography in Turkey: what the test is and how it works
Hysterosalpingography, usually shortened to HSG, is an X-ray test that outlines the inside of the womb and shows whether the fallopian tubes are open. A thin catheter is placed at the cervix and a liquid contrast dye is injected gently into the womb. The dye fills the cavity, runs along the tubes and, if they are open, spills out at their ends into the pelvis; X-ray images taken during the injection record each step. The test is one of the first investigations offered to couples who have not conceived, because blocked tubes or a distorted womb cavity are common, treatable causes of infertility.
This guide explains when the test is done, how it feels, what it can and cannot show, how it compares with other tubal tests, what it costs in Turkey compared with the UK, US and Germany, and how to prepare. HSG is usually part of the wider work-up described in our IVF treatments in Turkey hub.
Why do doctors ask for hysterosalpingography?
The main reason is to check that at least one tube is open so that an egg and sperm can meet. It also shows the shape of the womb cavity and can reveal polyps, fibroids pressing into the cavity, scar tissue (adhesions), a septum or other differences in shape. Guidelines such as the NICE fertility guideline recommend testing for tubal blockage in women with no known reason for infertility. The result decides which treatment is sensible: if the tubes are open and the cavity is normal, simpler treatment may be tried first; if both tubes are blocked, IVF is usually the next step. See complex diagnostics of infertility for women for the other tests.
When in the menstrual cycle is the test done, and how do you prepare?
The test is normally done in the first half of the cycle, after bleeding has stopped and before ovulation, usually between about day 6 and day 12. This avoids an early pregnancy and gives the clearest view of the womb lining. You must not be pregnant, so use reliable contraception or avoid intercourse in that cycle. Some clinics give a simple painkiller about an hour beforehand and, if you have had pelvic infection before, antibiotics. Tell the doctor about allergies, especially to iodine-based contrast, and about any recent pelvic infection or unexplained discharge. Bring any previous scans or reports.
What happens during an HSG, and is hysterosalpingography painful?
You lie on an X-ray table, a speculum is placed in the vagina as for a smear test, the cervix is cleaned and a thin tube is inserted. Contrast dye is injected slowly while the radiologist or gynaecologist takes several X-ray images. The test itself takes about 5 to 10 minutes and the visit around 30 to 45 minutes. A small amount of radiation is used, comparable in scale to other routine pelvic X-rays; the dose to the ovaries is low, and the doctor will keep the exposure as small as possible. Results are usually available the same day on the images, with a written report to follow.
Pain: most women feel period-like cramps for a few minutes when the dye is injected; for some it is mild, for others sharper, especially if a tube is blocked and the pressure rises. Simple painkillers beforehand help. Deep breathing and a calm, gentle operator also make a difference. A few women feel faint (a vasovagal reaction) and should tell the team. Pain usually settles within minutes; a dull ache or light spotting for a day or two is common. Severe pain, fever or foul discharge afterwards needs a call to the clinic.
What can HSG show, and what are its limits?
HSG shows whether dye passes through the tubes, a swollen blocked tube (hydrosalpinx) and the outline of the cavity. It does not show the ovaries, endometriosis, adhesions outside the tubes or how well the tubes work. Spasm of the tube opening can look like a blockage, so a blocked result sometimes needs repeating or another test. Some studies, including a large Dutch trial of oil-based contrast, found that flushing the tubes may slightly raise the chance of pregnancy in the months after the test, but this is not a treatment on its own and should not be promised by a clinic.
HSG, HyCoSy or laparoscopy: which tubal test?
Several tests check the tubes. HSG uses X-rays and contrast. HyCoSy (hysterosalpingo-contrast sonography) uses ultrasound and a harmless contrast, avoiding radiation. Laparoscopy with dye test is an operation under general anaesthesia that sees the tubes and pelvis directly and treats some problems at the same time. Hysteroscopy looks inside the womb with a camera.
| Test | Best suited to | Typical limits |
|---|---|---|
| HSG (X-ray) | First test of tubes and womb cavity | Radiation; cannot see ovaries or outside the tubes |
| HyCoSy (ultrasound) | Women who prefer to avoid radiation | Needs skilled operator; less detailed cavity view |
| Laparoscopy with dye | Suspected endometriosis or adhesions; treatment at the same time | Surgery and anaesthesia; higher cost |
Hysterosalpingography cost in Turkey, the UK, US and Germany
The ranges are approximate for the test alone, not hospital quotes.
| Country | Approximate cost range |
|---|---|
| Turkey | €60 – €250 |
| United Kingdom | €250 – €700 |
| United States | €400 – €1,500 |
| Germany | €200 – €600 |
The price depends on the centre, whether a gynaecologist or radiologist reports it, the contrast type and whether the consultation and report are included. HSG is usually only one item in a fertility work-up, so check what else the quote covers: ultrasound, hormone blood tests, semen analysis and a consultation. If you travel, ask whether the test can be done in the same trip as a consultation and, if needed, pharmacological stimulation for IVF planning.
Who should not have an HSG?
HSG is not done if you are or may be pregnant, if you have an active pelvic infection, if you have a known severe allergy to iodine-based contrast or if you are bleeding heavily. A previous pelvic infection or known blocked tube needs antibiotic cover and careful discussion, because dye can cause flare-ups of infection. If the history suggests blocked tubes, a laparoscopy or another approach may be preferred. People with thyroid disease should mention it, as iodine-containing contrast can affect the thyroid in rare cases.
What does recovery look like, and how long should you stay?
Recovery is quick. Most women go back to work the same day or the next. Expect light spotting and mild cramps for one or two days; you may notice a watery, dye-tinged discharge. Many clinics advise avoiding intercourse, tampons and baths for about two days. For travellers, one to two nights in Turkey is enough for the test and a consultation about the result; a longer stay is only needed if it is combined with further treatment. A short flight home the next day is normally fine.
What are the risks of hysterosalpingography?
The commonest effects are cramps, spotting and a vasovagal faint. Less often a pelvic infection (pelvic inflammatory disease) occurs, which is why fever, worsening pain or foul discharge should be reported. Allergic reactions to the contrast are rare, and the radiation dose is small but not zero. Rarely the dye enters a blood vessel or the womb wall is injured. The US FDA and professional radiology bodies recommend using the lowest possible radiation dose. If the result is blocked tubes, IVF treatment or, in selected cases, intrauterine insemination may be discussed.
How do you choose a clinic for HSG, and what should you ask?
Choose a licensed centre where the test is done by a gynaecologist or radiologist who performs it regularly, with a written plan, a stated price and a report in English you can show your own doctor. Be cautious about quotes that bundle unnecessary treatments or promise pregnancy as a result of the test. Read how our process works and request your plan through the free quote page.
- Is the test X-ray HSG or ultrasound HyCoSy, and which contrast is used?
- On which cycle day will it be done, and do I need antibiotics?
- Will I receive the images and a written report in English?
- What happens if the result shows a blocked tube?
- Which other fertility tests are included in the price?
Hospitals with IVF & Fertility in Turkey
Frequently asked questions
Hysterosalpingography (HSG) is an X-ray test in which contrast dye is injected through the cervix to show the shape of the womb cavity and whether the fallopian tubes are open. It is a standard fertility test.
Most women feel period-like cramps for a few minutes while the dye is injected, ranging from mild to sharp. A simple painkiller beforehand helps, and discomfort usually eases within minutes, with a dull ache for a day or two.
Approximate ranges are €60 to €250 in Turkey and about €250 to €700 in the UK. The price depends on the centre, who reports the images and whether a consultation is included; ask for a written quote.
Usually in the first half of the cycle, after bleeding stops and before ovulation, roughly between day 6 and day 12. This avoids early pregnancy and gives the best view of the womb lining.
No. It shows whether the tubes are open and what the womb cavity looks like, but not ovulation, egg quality, sperm or endometriosis. Other tests are needed for a full picture.
The injection and X-rays take about 5 to 10 minutes and the whole visit around 30 to 45 minutes. Results are usually visible the same day, with a written report to follow.
HSG uses X-rays and contrast dye, while HyCoSy uses ultrasound and a harmless contrast so there is no radiation. HSG shows the cavity in more detail; HyCoSy depends more on the operator's skill.
Some studies suggest that flushing the tubes, especially with oil-based contrast, may slightly raise the chance of pregnancy in the following months. It is not a treatment and no clinic should promise it.
It is a low-risk test. Cramps, spotting and fainting are the commonest effects, while infection, allergy to the contrast and radiation exposure are uncommon and kept low by good practice.
One to two nights is enough for the test and a consultation about the results. A longer stay is only needed if you combine the test with further fertility treatment.