To demonstrate tubal patency, spillage of the material into the peritoneal cavity needs to be observed.

Hysterosalpingography has vital role in treatment of infertility, especially in the case of fallopian tube blockage.

[4] A meta-analysis revealed 3.6 times greater odds (OR = 3.6) of pregnancy with oil-based contrast compared to no hysterosalpingography.

[5] This effect is thought to be due to the flushing action of the contrast into the uterus that causes dislodgement of mucus plug, debris, or opening of mild adhesions in the fallopian tubes.

[6] HSG is contraindicated during menstruation, suspected cancer, pregnancy, unprotected sexual intercourse during the menstrual cycle, any purulent discharge from the vagina, or if the individual was diagnosed with pelvic inflammatory disease six months previously.

The contrast media should be prewarmed to room temperature before administered into the cervix, so as to prevent spasm of fallopian tubes.

[7] Images are taken to demonstrate the filling of endometrial cavity, which shows full view of the fallopian tubes demonstrating the spillage of contrast material into peritoneum, the extent of the block if no spillage is present, or a delayed view in the case of abnormal cavities (locule) within.

Lipiodol was introduced by Sicard and Forestier in 1924, and remained a popular contrast medium for many decades.

If the HSG indicates further investigations are warranted, a laparoscopy, assisted by hysteroscopy, may be advised to visualize the area in three dimensions, with the potential to resolve minor issues within the same procedure.