Hysterosalpingography

Hysterosalpingography (HSG) is a long-established fluoroscopic procedure that remains an essential method for evaluating female infertility and detecting uterine and tubal abnormalities. This chapter reviews the indications, contraindications, techniques, and imaging findings of HSG in both normal and abnormal conditions. Uterine pathologies such as myomas, endometrial polyps, adenomyosis, intrauterine adhesions, and malignancies are described, together with adnexal diseases including pelvic inflammatory disease, salpingitis isthmica nodosa, hydrosalpinx, and peritubal adhesions. Congenital Müllerian duct anomalies, including septate, unicornuate, bicornuate, and didelphys uteri, are also discussed with attention to their embryologic background, radiographic features, and reproductive outcomes. The diagnostic roles of complementary imaging techniques such as magnetic resonance imaging and ultrasound are compared. The chapter also reviews the diagnostic and potential therapeutic aspects of Lipiodol HSG in patients with infertility. By integrating technical considerations and interpretive criteria, this chapter aims to provide a concise and practical reference for radiologists and clinicians involved in infertility evaluation.

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