In the evaluation of tubal factor infertility, hysterosalpingography is routinely scheduled in the early proliferative phase of the cycle. The PRIMARY reasons for this timing are:

• A Because tubal spasm is absent throughout the follicular phase
• B To maximise therapeutic benefit of oil-based contrast on tubal patency
• C To avoid inadvertent irradiation of a possible early pregnancy and to prevent endometrial hypertrophy obstructing tubal ostia ✓
• D Because contrast flows retrograde into the ovaries only in the proliferative phase

Explanation

HSG is done between cycle days 6 and 12, after menstruation stops but before ovulation, so that a fertilisation-age pregnancy is excluded before pelvic irradiation and the thin proliferative endometrium does not block the cornual ostia or form filling defects. Option B describes a real but secondary benefit of oil contrast, not the reason for timing. Tubal spasm causing false cornual blockage can occur at any phase, so A is wrong.

Reference: Berek and Novak's Gynecology, 16th ed.

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Written and medically reviewed by the StethoPrep medical team.