Warming Contrast Media for Hysterosalpingography

• incidence of vasovagal episodes [ Time Frame: from the injection of the media to a half hour after HSG ] [ Designated as safety issue: Yes ]
  vasovagal episodes include nausea, Vomit, Sweating, Weakness and bradycardia occurred in HSG
  
  

• Visual analogue scale pain score during HSG [ Time Frame: within the first 30 seconds after the constra media "spill out" ] [ Designated as safety issue: No ]
  assessing the average pain score during HSG,Immediately after the constra media "spill out" the tubal fimbria and spread into periotneum.
  
  
• Visual analogue scale pain score after HSG [ Time Frame: a half hour after HSG ] [ Designated as safety issue: No ]
  10cm Visual analogue scale pain score after HSG
  
  

As an essential step of the infertile work-up, hysterosalpingography remains widely used in many country since it was first reported at 1914. Although HSG is a non-invasive and safety procedure, it still has some adverse. Lower abdominal pain and vasovagal episodes are mainly acute reactions to the contrast media of HSG, the later include nausea, Vomit, Sweating, Weakness and even bradycardia, occur in 16-54% of patients undergoing HSG.

Many techniques were developed to reduce adverse reactions or alleviate the pain in using of contrast media, include previous analgesia, pretreatment with corticosteroids and using non-ionic contrast media for HSG. However, in a recently Cochrane's review, reported it lack of benefit for using any pain relief medication in HSG.

Pre-Warming the hands and instruments makes physical examination more comfortable for the patients. Local active warming can valid lessen the acute pelvic pain. Experiences from the peritoneal dialysis and the laparoscopy surgical reveal that warm dialysis solution or air insufflation can decrease the pain of operation. A randomize study on Sonohysterography (SHG), another technique for exam tubal and uterine cavity diseases, cue that warming of Echovist contrast media to body temperature is a simple and effective intervention in reducing discomfort at the time exam.Because the less volume of medium injected during the HSG and the iodine medias may have different properties to the Echovist media, whether this intervention is also valid in HSG remains unknown.