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Harvard Medical School
It is common for patients to have a small amount of bleeding from the vagina and some pelvic cramping for a few days after the procedure. If you have heavy bleeding, fever, or increasing pain in the pelvis, you should call your doctor. Some women experience an allergic reaction to the contrast dye. The most significant risk from this procedure is infection, which happens in close to 3 out of 100 patients. Most doctors use a water-soluble dye when they do this procedure; this dye does not usually irritate the uterus.
As with x-rays, there is a small exposure to radiation. In large amounts, exposure to radiation can cause cancers or (in pregnant women) birth defects. The amount of radiation from a hysterosalpingogram is too small to be likely to cause any harm. However, since the x-ray exposure is directed right at the pelvis and ovaries, it is very important to be sure you are not pregnant at the time of the test.