Hysterosalpinography (HSG) is a routine test for female infertility. It is performed by injecting contrast into the uterine cavity and fallopian tubes through a catheter, fluoroscopy and radiography, and then analyzing the degree of patency of the fallopian tubes, the site of obstruction and the morphology of the uterine cavity based on the visualization of the contrast in the fallopian tubes and pelvis. This is a visual examination method and has some therapeutic effects. It is safe and generally does not require anesthesia and is painless. For those who are sensitive to pain, painless hysterosalpingography can be done in our hospital. Indications 1. Female infertility with no abnormality in the husband’s semen examination, with a biphasic basal body temperature (BBT) and good luteal function for 3 consecutive menstrual cycles, but still unable to conceive. 2.History of lower abdominal surgery such as appendectomy, cesarean operation; history of pelvic inflammatory disease such as gonorrhea infection, puerperal infection. 3.History of chronic appendicitis or peritonitis, now suffering from endometriosis, etc., who have been treated for infertility and suspected of having tubal obstruction. 4.Observation of uterine cavity morphology to determine the presence of uterine malformation and its type, the presence of uterine cavity adhesions, submucosal fibroids, endometrial polyps and foreign bodies, etc. 5.Laparoscopic examination of extra-luminal adhesions of the fallopian tubes and preoperative examination when tubal plastic surgery is proposed, because HSG can further provide information about the situation in the lumen of the fallopian tubes. 6, history of multiple mid-trimester spontaneous abortions with suspected endocervical dysplasia, and observation of endocervical relaxation at the time of non-pregnancy. Contraindications 1.Acute and subacute internal and external genital inflammation. 2.Serious systemic diseases. 3.Pregnancy, menstruation, within 6 weeks after hysterectomy. Preparation for the examination 1.Contrast time 3-7 days after menstrual purification. 2.No acute or subacute pelvic inflammatory disease, such as no inflammatory masses or pressure pain at both sides of the adnexa, and body temperature below 37.5℃. 3.Leukostasis suspension examination shows no trichomonas or mycobacterial infection in the vagina. 4.No intercourse 3 days before the imaging. 5. Urine should be emptied before imaging. After the examination, it is forbidden to take a tub bath and have sex for 2 weeks after the imaging, and antibiotics can be given as appropriate to prevent infection. 2.Sometimes the tubal spasm may cause the illusion of tubal incompetence, so repeat the procedure if necessary. 3. A small amount of vaginal bleeding within one week after imaging is normal if there is no other discomfort. 4. It is best to use contraception for three months after imaging to reduce the possible effects of x-ray exposure. Clinically, it is observed that women who become pregnant in the same month after imaging do not have an increased risk of fetal abnormalities; however, prenatal examinations must be done so that abnormalities can be dealt with in time. Examination steps 1. Do the imaging with the patient lying supine on the X-ray machine operating platform and take the bladder truncal position. The vulva and vagina are routinely disinfected and a sterile towel is placed. The position and size of the uterus are checked again. 2.Dilate the vagina with a speculum, expose the cervix, and disinfect the cervix and fornix with iodophor. Then insert the cervical canal in the direction of the uterine cavity, inject 1.5 ml of air, and pull the catheter tightly outward to make it adhere to the cervix to prevent leakage during drug injection. 3. Observe the flow of the contrast medium through the uterine cavity and fallopian tubes under X-ray fluoroscopy and take pictures. Slowly inject the contrast agent under fluoroscopy. Observe the flow of contrast into the uterus and through the fallopian tubes and take pictures while observing. After the contrast is injected, a certain amount of time is needed (the time varies depending on the contrast) and a diffusion film is taken, usually 4-6 films are taken. Therapeutic implications Palmer (1960) reported that those with multiple HSG showing patency of the fallopian tubes had a conception rate of 76% within 1 year, which was 3 times higher than those without HSG. The therapeutic effect of HSG on infertility may be due to: 1. mechanical flushing of the fallopian tubes by the injected contrast medium. 2. The pulling effect on the cervix during contrast may dissociate certain mild adhesions around the fallopian tubes. 3.Iodine can evenly coat the mucosal surface of the fallopian tube, which can give full play to the local bactericidal effect of iodine. 4.It can improve the mucus environment of the cervical canal. 5.Iodine agent has slowed down the phagocytosis of monocytes during in vitro experiments and may have reduced the phagocytosis of sperm by monocytes in vivo. Side effects The side effects of tubal angiography are minimal and almost non-existent, but there are some contraindications that need to be noted. However, there are some contraindications to be aware of. Strict asepsis can effectively avoid the side effects of tubal angiography.