Do You Need a Hysterosalpingography? Fertility Changes at 33

Hysterosalpingography (HSG)

Hello, doctor.
I recently had a transvaginal ultrasound, and both my ovaries and uterus appeared normal.
My menstrual cycle occurs every 26-28 days.
About eight years ago, I was pregnant, but I was too young to consider carrying the pregnancy to term.
Now, at 33 years old, my husband and I are in a long-distance relationship, so we have limited sexual activity.
Do I need to undergo a hysterosalpingography to check if my fallopian tubes are open? Since I have been pregnant before, I would like to know if the condition of the fallopian tubes can change with age.
Thank you.

Cherry, 30~39 year old female. Ask Date: 2013/06/13

Dr. Lin Wenbin reply Obstetrics and Gynecology

Please visit a fertility clinic for consultation.
Since you are already 33 years old and have limited sexual activity, you may need some assisted reproductive techniques to improve your chances of conception.
After an evaluation by the physician, selecting the right timing for intercourse might suffice, and you may not need more complex procedures like in vitro fertilization (IVF) to achieve a normal pregnancy.
The condition of the fallopian tubes can indeed change due to age or frequency of sexual activity, so an examination is necessary to determine your current status.

Reply Date: 2013/06/13

More Info

When considering whether to undergo a hysterosalpingography (HSG) at the age of 33, especially in the context of fertility, it's essential to understand both the procedure and the factors that may affect your reproductive health.
Hysterosalpingography is a specialized X-ray procedure used to examine the uterus and fallopian tubes. During the procedure, a contrast dye is injected into the uterine cavity through the cervix, allowing for imaging of the uterine structure and the patency (openness) of the fallopian tubes. This test can help identify any abnormalities such as blockages, fibroids, or structural issues that could impact fertility.

Given your history of a previous pregnancy, normal ultrasound findings, and regular menstrual cycles, it may seem that your reproductive health is intact. However, age can play a significant role in fertility. While 33 is still considered a relatively young age for conception, fertility does begin to decline in women, particularly after the age of 35. Factors such as the quality of eggs and the health of the reproductive system can change over time, even if you have had a successful pregnancy in the past.

Here are some considerations to help you decide whether an HSG is necessary:
1. Current Fertility Goals: If you and your partner are actively trying to conceive and have been unsuccessful for a year or more, it may be worthwhile to investigate further. The HSG can provide valuable information about your reproductive anatomy.

2. Menstrual Regularity: Your regular menstrual cycles (26-28 days) suggest that ovulation is likely occurring, which is a positive sign for fertility. However, regular cycles do not guarantee that there are no underlying issues affecting fertility.

3. Previous Pregnancy: While having been pregnant before is a good indicator of fertility, it does not rule out the possibility of developing issues such as tubal blockages or uterine abnormalities over time.

4. Age-Related Changes: As you age, the risk of conditions such as endometriosis or pelvic inflammatory disease increases, which can affect the fallopian tubes. An HSG can help identify if there are any changes that may have occurred since your last pregnancy.

5. Partner's Fertility: It’s also important to consider your partner's fertility. If there are concerns on his side, a comprehensive fertility evaluation for both partners may be warranted.

6. Consultation with a Specialist: Before making a decision, it may be beneficial to consult with a fertility specialist. They can provide personalized advice based on your medical history, current health, and fertility goals.

In summary, while your current health indicators are promising, an HSG can provide additional insights into your reproductive health, particularly regarding the patency of your fallopian tubes. If you are considering trying to conceive and have concerns about your fertility, discussing the possibility of an HSG with your healthcare provider could be a prudent step. They can help you weigh the benefits and risks of the procedure in the context of your overall fertility plan.

Similar Q&A

Should I Consider Hysterosalpingography for Fertility Boost?

Hello, Director Cao. I have been married for nearly a year without using contraception and have not conceived. Six months after marriage, I underwent one cycle of artificial insemination, which was unsuccessful. My husband is not very proactive about having children, but I really...

Dr. Cao Guotao reply Obstetrics and Gynecology
Hello, the general definition of infertility is the inability to conceive after one year of regular sexual intercourse. In cases of infertility, both partners should undergo examinations at a gynecology clinic, including semen analysis, hysterosalpingography, ovulation testing, a...

Is Hysterosalpingography Necessary for Fertility Issues?

Hello, I gave birth to my first child in 2003, and since last year, I have not used contraception but have not become pregnant. I visited a gynecologist, and the doctor arranged for a hysterosalpingography (HSG). I have a few questions: (1) The HSG requires the injection of a con...

Dr. Wei Fumao reply Obstetrics and Gynecology
(1) It is difficult to determine if there is an allergy. (3) If there is a blockage, it can be checked; if both sides are blocked, conception may be difficult, but if only one side is blocked, one can wait. (4) Laparoscopy can be used to observe the condition of the pelvic cavity...

Do I Need Another Hysterosalpingography for Fertility Concerns?

Hello, doctor. I would like to ask, I underwent a hysterosalpingography in July 2019, and both sides were normal. I naturally conceived in August and had a spontaneous miscarriage in October. I conceived naturally again in February 2020, but in May, due to the absence of a fetal ...

Dr. Cao Guotao reply Obstetrics and Gynecology
Hello, you can temporarily avoid undergoing a tubal examination and just observe for now. Wishing you good health.

Essential Fertility Tests: Should You Consider Hysterosalpingography?

Hello Dr. Tsao, I would like to inquire about preparing for pregnancy. I have already had blood tests for ovarian function, progesterone, and other relevant tests, all of which are normal. I have also been taking ovulation medication for two months and have been tracking my basal...

Dr. Cao Guotao reply Obstetrics and Gynecology
Hello, if your hormone levels are normal and ovulation is regular but you have not become pregnant, it is recommended to undergo a hysterosalpingogram (HSG) and semen analysis if you have not conceived after one year. This will help identify any potential issues. Wishing you good...