HSG- Hysterosalpingogram

This post is a little TMI just so you know exactly what you are getting into!

First off, if you’re reading this then you might be going through some sort of fertility issues and for that I’m sorry. You are not alone.

My HSG test was done after trying to conceive for over a year and about 4 months after my miscarriage. My OBGYN/ fertility specialist recommended this test shortly after my first visit to him for fertility issues (after trying for almost a year) because it shows you (and the doctor) if there are any blocked tubes or uterus abnormalities. He also recommended it because it has been shown to increase your chance to conceive for a couple months after it is done, especially for women with unexplained infertility. (My doctor said 3 month increase in fertility) I had already started my first cycle with clomid and we decided to give that a month, try a month with clomid and femara, and then HSG the next month if I wasn’t pregnant. We were very fortunate to conceive on the first round with just clomid. (50mg on days 5-9) After we lost the baby I had completely forgotten about the HSG and decided to give clomid another try. We did two clomid only cycles, two clomid and femara together cycles (this is when I remembered HSG), and then after a bad reaction to femara I did another (my last) just clomid the same month I had the HSG done.

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HSG is done on certain days of your cycle. My doctor likes to do them on days 7-11. So you have to call and get on the schedule as soon as a new cycle starts or you’ll have to wait until the next month and try again, like I had to. Some doctors are able to do this at their office but mine was done at the hospital, which might be why scheduling was so restricted. When I scheduled my test the nurse said that my doctor recommends taking two Tylenol before arriving at the hospital, which I did. I like to know all the details I can so I’ll be completely open and honest. This is my take on how this test was explained to me: Get to appointment early to fill out registration (only took 15 minutes and all I had to do was sign my name a couple times) Taken to radiology area of hospital since the test involves X-ray. Given a couple gowns to put on each way to be as modest as possible (even though you’re about to be spread eagle on a table in a room full of people) told to remove clothes from waist down. I’m always cold so I was excited I could keep my long sleeve shirt on! My doctor came in, greeted us, and had everyone (Including Tim) put on the protective gear since they would all be present during the X-ray. Tim was allowed to stay in the room and stood beside the bed/table I was laying on. They had me lay on my back with my legs bent just like at your annual, or for a transvaginal ultrasound.

 The nurse had described what would be happening before the doctor came in and he described everything he was doing. Basically, he inserts the same thing that’s used during a pap smear (a speculum), and then a catheter is placed (vaginally), which is used to put the dye directly into the uterus. Once the dye is in the uterus a small balloon type thing sits on top of the cervix and keeps the dye from running back out. This forces the dye to fill the uterus and travel down the fallopian tubes spilling out the ends near the ovary. That is if both tubes are free from any blockages. The radiologist comes in and takes x-rays using a machine that hangs over you to localize the x-ray. Kinda like the overhead light at a dentist office but twice the size. They could move it exactly where it need to be but I wasn’t “in” a machine like an MRI. In my case both tubes were clear and the fluid spilled out of both sides like it was supposed to. The doctor said my left tube had a moment where the flow briefly stopped which could mean a small mucus blockage that the dye broke up or a small spasm that caused the dye to stop momentarily. Either way the dye was able to move throughout the tube within seconds. Since I had gotten pregnant once before I felt like at least one tube was probably unblocked but it was nice to know for sure.

I had read a few posts and comments about the pain people experienced with this test so I was somewhat nervous because my last (and only) hospital experience was so dramatic. I’m happy to report that I did not have any “pain” during this test! This could be partly because my tubes were not blocked so there wasn’t a build up of pressure where the dye was trying to push it’s way through. There was definitely some pressure when the speculum was inserted where I thought this procedure might end up being painful. But that was the worst part. I had some mild discomfort when the catheter went through the cervix but it was more of a weird feeling than anything painful. I also had some very mild cramps, not even a bad as a menstrual cramp. Once everything was removed and the test was over I felt totally normal. Before leaving the hospital the nurse gave me a giant pad and a washcloth. I cleaned up in the bathroom in the room and had a couple spots of bright red blood, probably from the catheter going through the cervix. TMI, but I said I would be honest, as we walked to the car I could feel some of the dye coming back out but that’s what the giant pad is for. This part was pretty much finished about an hour and half after the test was over. (The ink is clear but discharge was pink/brownish-totally normal) I did continue to experience cramps off and on throughout the day but not like a normal cycle and I didn’t take any pain medicine. I could have definitely driven myself but it was nice to have Tim there and not have to worry about anything. The only unexpected thing I experienced was a bad taste in my mouth for several hours afterwards. I’m not sure if this was from the dye or something else. It wasn’t so bad as to make me feel nauseous and it meant I was drinking more water to try to get it to go away.

 A timeline for the day went like this:

• 6:50 AM- Took two Tylenol as instructed previously by doctor
• 7:00 – Arrived at hospital
• 7-7:15- Registration
• 7:15-7:20- Walk to radiology area and wait to be called back
• 7:20-7:32- Changed into gowns, went over what would happen with nurse
• 7:32- Doctor came in and got set up, I laid down on table.
• 7:35- Procedure began
• 7:45- Results and Questions
• 7:55- Everything was finished and I was back in my regular clothes thinking about breakfast.

 I hope this was able to give you more insight into what to expect if you or someone you know is planning to have this test done. I had read so many negative stories revolving around this test and wanted to make sure there was a positive one out there!