What To Expect During Your HSG


What To Expect During Your HSG

A hysterosalpingogram (HSG), is a fairly standard part of the infertility testing protocol. The test allows doctors to view the interior walls of your fallopian tubes and uterus, specifically looking for blockages or irregular shapes/contours that prevent conception or cause miscarriages.

How Does an HSG Work?

HSGs are one of the diagnostic tests that help us find anatomical causes of female infertility. If a fertility specialist doesn’t use an HSG for your initial fertility testing, s/he should absolutely schedule one if you’ve had trouble conceiving or if you’ve had multiple miscarriages.

HSGs are used to diagnose:

  • Blocked fallopian tubes (these could be formed during your own, in-utero development or the result of endometriosis, scarring from pelvic inflammatory disease or other STDs, prior reproductive surgeries, etc.)
  • Endometrial polyps
  • Fibroid tumors
  • Uterine scarring

HSGs are performed in a radiology lab because they are a type of x-ray procedure. They are outpatient and rarely take more than 30-minutes from start to finish.

The doctor inserts a small thin tube into the vagina and through the cervix and up through your uterus and fallopian tubes. Once in place, an iodine-based contrast dye is inserted to fill up these spaces. When these cavities fill with dye, the doctor uses the x-ray to evaluate where the dye goes – and where it can’t infiltrate. Your diagnosis will follow from there.

What Happens and What Does it Feel Like?

HSGs are scheduled in the window after your period but before you ovulate in order to gain the clearest images. Most often this means it is scheduled between Day 7 and Day 12 of your cycle. Other than being on time for your appointment, no preparation is necessary. You do not need to fast, and no anesthesia is required.

Once you’ve undressed from the waist down, you’ll lay down on a table similar to the one at your OB/GYN’s office and put your feet in the stirrups. The nurse or doctor will insert a speculum  and the HSG procedure will continue from there.

Will it hurt?

This answer varies from woman to woman. Almost all women feel something, most often a warming sensation when the dye is injected. Some women feel discomfort, such as cramping, as the dye fills the tubal and uterine cavities. Women who report higher-than-normal discomfort or pain are typically those who:

  • Have a tubal blockage
  • Experience painful sexual intercourse
  • Are more prone to discomfort during their annual pelvic exam and routine pap smears
  • Are allergic to iodine (let your doctor know if you’ve reacted to iodine or a contrast dye in the past and if you have shellfish allergies)
  • Have a history of PID or other pelvic infections (which also increases your risk of post-HSG infection. Always remind the doctor if you have had pelvic infection(s) in the past.

To minimize discomfort, you are welcome to take an over-the-counter anti inflammatory or pain reliever such as ibuprofen at least 30 to 60 minutes prior to the procedure.

If you experience pain beyond a bit of anticipated discomfort, let the doctor know immediately. This is not the time to “grin and bear it.” We want to remain informed so we can make adjustments or withdraw altogether, such as a case where we suspect an allergic reaction.

What Can I Expect After the HSG Procedure?

Here are some things to prepare for after the procedure:

  • Have a friend on hand. While we don’t use anesthesia or sedatives that prevent you from driving home safely, you may feel a little crampy afterwards. Having a friend along for moral support and to drive you home is a good idea. Dizziness and even fainting are potential risks. If you feel dizzy during or after the procedure, let us know and please remain in the hospital or fertility center until any dizziness has completely faded.
  • Take antibiotics as prescribed. To minimize the risk of potential infection, we prescribe an antibiotic. You’ll begin taking this the day before your procedure, and you should continue to take it as prescribed until the prescription is used up.
  • You may experience cramps or light spotting. This is normal and there is no cause for concern as long as they remain on the “lighter/normal” side. You are welcome to use over-the-counter pain relievers to reduce cramping or discomfort. Contact your doctor if you experience intense cramps, more severe discomfort, increasing pain, or a fever.
  • Avoid having sex for at least two or three days. We understand that your HSG test may take place a few days before your most fertile window. However, to minimize any risk of infection, we ask that patients refrain from having sexual intercourse for a few days following the procedure.

Any discomfort or spotting typically goes away within a day or two.

Keep Open Lines of Communication With Your Doctor

It’s perfectly normal to have the jitters or to feel some level of trepidation before your HSG. Do not be afraid to communicate this to your doctor and the nurse(s). It’s important to us that our patients feel comfortable and confident as possible with their infertility diagnosis and treatment process. We are here to support you every step of the way.

Contact the Fertility Center of Dallas if you feel your current infertility diagnosis is incomplete or you are looking for a fertility specialist who provides advanced, innovative fertility solutions in the spirit of compassionate hope and personalization.

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