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Causes of infertility include male factors and female factors. Female infertility can involve problems with ovulation or pelvic abnormalities. Normally, sperm is deposited within the vaginal vault, some of this sperm will live comfortably within the cervical mucus for a few days, sperm from the cervical mucus travels across the uterine cavity into the fallopian tubes, fertilization of the mature egg occurs within the fallopian tube, the fertilized egg (preimplantation embryo) develops in the tube for several more days, the late morula or early blastocyst stage preimplantation embryo enters the uterine cavity, and the embryo hatches and implants into the uterine lining. This normal sequence of events can become much less efficient (successful) whenever an abnormality is present. 

The hysterosalpinogram (HSG) is a common, relatively inexpensive, safe, radiological test that involves fluoroscopy and a radio-opaque distention medium. The operator (usually a radiologist or an infertility doctor) injects the distending media into the uterine cavity and it normally fills and then spills from the fallopian tubes into the pelvis. The hysterosalpingogram (HSG) should allow the physician to determine whether there are any filling defects (such as endometrial polyps, submucosal fibroids, adhesions or synechiae) within the uterine cavity and the patency of the fallopian tubes. If there are filling defects within the uterine cavity or blocked fallopian tubes then fertility can be reduced. There are some reports, but no really scientific study, suggesting that the HSG (hysterosalpingogram) procedure may actually improve fertility rates by “blowing out” the fallopian tubes (removing any material that might be partially clogging the tubes). 

A sonohysterogram (also called a saline ultrasound or hystersonogram) uses saline to fill the uterine cavity while it is being examined using a high resolution ultrasound machine. Sonohysterography often allows the operator to visualize any defects within the uterine cavity (such as polyps, sub-mucosal fibroids, adhesions or intrauterine synechiae) with the same or even greater sensitivity compared to the hysterosalpingogram. However, the visualization of the fallopian tubes and their patency is generally much less reliable when performing a sonohysterogram as compared to the hysterosalpingogram. Therefore, we generally suggest the hysterosalpingogram as an initial test for the uterine cavity and the patency of the fallopian tubes and followup with the sonohysterogram if an intracavitary lesion needs further evaluation.

Many women have apparently had significant discomfort with the hysterosalpingogram test. At The NJ Center for Fertility and Reproductive Medicine, LLC, Dr. Daiter offers to personally perform every hysterosalpingogram (HSG) that he suggests since discomfort with the procedure is truly rare when he performs it. For an appointment to discuss your situation with Dr. Daiter, please call the office at 908 226 0250. Visit us on the web at http://www.drericdaitermd.com http://www.ericdaiter.com and http://www.infertilitytutorials.com

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