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Updated: Dec 31, 2025

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Hysterosalpingography in endometriosis: performance and interpretation.

Aoife Kilcoyne1, Aileen O'Shea2, Debra A Gervais2

  • 1Department of Radiology, Harvard Medical School, Massachusetts General Hospital, Boston, MA, 02114, USA. akilcoyne1@partners.org.

Abdominal Radiology (New York)
|January 4, 2020
PubMed
Summary

Hysterosalpingography (HSG) is a key imaging tool for diagnosing endometriosis in infertile patients. This review details HSG techniques, findings, and reporting for endometriosis evaluation.

Keywords:
AdenomyosisFallopian tubeFemale pelvic imagingGynecologyInfertilityMullerian anomaliesPelvic adhesionsPeritubal adhesionsTubal occlusion

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Area of Science:

  • Reproductive Medicine
  • Diagnostic Imaging

Background:

  • Endometriosis is a common gynecological condition affecting women of reproductive age.
  • Infertility is a frequent complication of endometriosis.
  • Hysterosalpingography (HSG) is a standard imaging modality for infertility workup and can reveal signs of endometriosis.

Purpose of the Study:

  • To elucidate the role of hysterosalpingography (HSG) in evaluating infertile patients with suspected or confirmed endometriosis.
  • To provide a comprehensive overview of HSG technique, interpretation, and reporting in the context of endometriosis.

Main Methods:

  • Review of existing literature and clinical experience regarding HSG in endometriosis.
  • Detailed description of HSG procedure, including patient preparation, technique, and potential risks.
  • Illustration of characteristic HSG imaging findings suggestive of endometriosis.
  • Presentation of a standardized reporting template for HSG in endometriosis cases.
  • Discussion of common imaging pitfalls and their resolution.

Main Results:

  • HSG can identify specific patterns and signs indicative of endometriosis, such as hydrosalpinx, tubal blockage, and peritubal adhesions.
  • The technique allows for assessment of uterine cavity and fallopian tube patency, crucial for fertility evaluation.
  • Standardized reporting enhances diagnostic accuracy and communication between radiologists and clinicians.

Conclusions:

  • HSG is a valuable, accessible imaging method for the initial diagnosis and evaluation of endometriosis in infertile women.
  • Understanding HSG findings and potential pitfalls is essential for accurate diagnosis and patient management.
  • HSG contributes significantly to the multidisciplinary approach to managing endometriosis-associated infertility.