If your doctor or RE suspects a blockage in or narrowing of your fallopian tubes, she may have ordered a hysterosalpingogram (HSG) for you. This diagnostic x-ray can be tremendously helpful in discovering facts about your fertility. It can also rule out suspected issues that aren’t actually occurring.
So don’t dread it … your HSG could prove to be one key to your personal fertility puzzle.
What the Test Can Tell You
An HSG is useful not only for viewing (via x-ray) the shape and condition of your fallopian tubes and any blockages, but also for looking at the size and shape of the uterus. Fallopian or uterine malformations and blockages can cause problems with getting or staying pregnant. Some of these issues can be treated with surgery or other means. So your RE will want to have this information before proceeding with your fertility treatment schedule.
The Test: Step by Step
- You will be awake during the procedure. Because you won’t be receiving general anesthesia (“sleeping” surgery), you probably will not need to fast the night before the procedure. Check with your doctor.
- Your doctor may recommend ibuprofen an hour before the procedure to make things more comfortable. Follow her instructions exactly.
- Your doctor may prescribe antibiotics in advance of the procedure as a preventive measure. Not all doctors do this. It depends upon your doctor’s preference.
- You will undress from the waist down and lie on a table like the one at your gynecologist’s office. You will be asked to place your feet in stirrups, just like during a regular gynecological exam.
- The doctor will perform a quick pelvic examination.
- She will then place a speculum into your vagina, and place a thin tube called a cannula through the opening of your cervix. An iodine-based dye will be injected through the cannula up into your reproductive organs.
- X-rays will then be taken of the area. You may be asked to change position so the doctor can get various views and angles of your reproductive organs. You will be asked to hold still and hold your breath for each x-ray.
- When the doctor feels she has all the x-rays she needs, the cannula will be removed and you can go home.
Does the Test Hurt?
That’s the big question, and you have every right to ask it — it’s your body.
When anything is placed inside the uterus (in this case, the cannula and the dye), it will generally react by cramping. Some women report no cramps, some women report mild cramps and some have moderate to severe cramps. It depends upon you and your body. Think of the pain during your period.
If you often feel discomfort during regular gynecological exams or other gynecological procedures, tell your doctor in advance of the procedure. She may prescribe ibuprofen or another regimen prior to the test to make things easier for you.
Don’t downplay your fears to your doctor. Anxiety tends to make any physical procedure less comfortable. If you’re afraid it will hurt, tell your doctor and ask for a pre-procedure regimen to help make your HSG as comfortable as possible. She’s there to help you; always ask questions.
Generally, no aftercare is required after an HSG. You may experience cramping from several minutes to several hours following the procedure. If you’ve ever had an IUD, the cramping will be similar to your post-IUD insertion cramps.
You may also spot following the procedure.
If your pain worsens, lasts more than a day, or if you experience spotting or spike a fever over 100F, call your doctor. She will give you instructions on what to do next.
Will I Get an Infection From the Procedure?
Fewer than 1% of HSG patients get an infection from the procedure.
Remember that the HSG is a very common procedure that your doctor may have done dozens of times or more. It is generally quick — half an hour or less — and it can give your doctor solid information on where to go from here with your fertility plan.
Ask your doctor when you can expect the results of the test and make a follow-up appointment to discuss your options.
If you’ve had this procedure done, please share your thoughts. I never had to go through this (this is Susan writing, not Chris, of course!), but we’ve had a few questions come up about it from readers.