Hysterosalpingogram (HSG)

What is an HSG?

A hysterosalpingogram (HSG) is an X-ray test that looks at the inside of the uterus and fallopian tubes and the area around them.

Why is an HSG done?

An HSG is usually performed for women that are having trouble becoming pregnant, or who have experience repeat miscarriages. The test will:

Check for a blocked fallopian tube. An infection may cause severe scarring of the fallopian tubes and block the tubes, preventing pregnancy. Occasionally the dye used during a hysterosalpingogram will push through and open a blocked tube.

Find problems in the uterus, such as an abnormal shape or structure, an injury, polyps, fibroids, adhesions, or a foreign object in the uterus. These types of problems may cause painful menstrual periods or repeated miscarriages.

How is an HSG performed?

During a hysterosalpingogram, a dye (contrast material) is put through a thin tube that is put through the vagina and into the uterus. Because the uterus and the fallopian tubes are hooked together, the dye will flow into the fallopian tubes. Pictures are taken using a steady beam of X-ray (fluoroscopy) as the dye passes through the uterus and fallopian tubes. The pictures can show problems such as an injury or abnormal structure of the uterus or fallopian tubes, or a blockage that would prevent an egg moving through a fallopian tube to the uterus. A blockage also could prevent sperm from moving into a fallopian tube and joining (fertilizing) an egg. A hysterosalpingogram also may find problems on the inside of the uterus that prevent a fertilized egg from attaching (implanting) to the uterine wall.

My experience:

Although I had already had an SHG, I requested an HSG 6 months later to make sure that no scarring had developed from my uterine septum resection.  Having just starting trying to get pregnant again after a long break, I also wanted peace of mind that everything was clear and no issues had developed.

I was instructed to schedule the HSG on CD1 of my menstrual cycle. The procedure needed to be done between days 5 and 10 of my cycle, and I was told to abstain from intercourse until 48 hours after the HSG. If I was still spotting the day of the procedure, I would have had to reschedule.

I took 3 advil an hour before the procedure. My appointment was at 1:30pm, and I arrived at 1pm to get registered. The nurse took me into a  scary looking room with a giant xray machine, a hospital bed and some intense looking stirrups. The nurse explained the procedure, and told me that the doctor would insert a catheter into the cervix and inject dye into the uterus, so that they can take x-rays. She asked me questions me questions about my history (how many times I’ve been pregnant, how many live births, surgeries I’ve had in the pelvic area, etc), and then I changed into my gown and waited for the doctor. When the doctor came in he explained the procedure again and asked if I had any questions.

I focused the entire time on trying to make my body relaxed. I tried un-tensing every single muscle I had. I took deep breaths and tried to focus on something else besides what was happening. The doctor inserted an extremely cold speculum, followed by the catheter. I immediately started feeling cramps, but very lightly and luckily very tolerable. He slowly injected the dye and as he did the cramps intensified, but were still tolerable. The nurse then started taking x-ray images, and I had to turn on either side of my hips for more images. After about 5 – 10 minutes the procedure was done. Once the speculum was taken out, the cramping subsided, although I did have slight cramping for the rest of the day. I was instructed to take it easy for the rest of the day, and refrain from baths, pools, and intercourse for 48 hours.

Click here to read my blog post about my HSG.