HSG stands for hysterosalpingogram (no wonder they abbreviate it). This is a quick test that is generally ordered by your OBGYN or your reproductive endocrinologist. Mine was ordered before my first IVF cycle by my reproductive endocrinologist, but after I had already done 3 medicated timed intercourse cycles and 3 IUIs. The timing of this test seems to vary between fertility patients, but is generally ordered pretty early on in your fertility journey. 

After a speculum is placed (think pap smear) a thin catheter is threaded in. Dye is then passed through your uterus and fallopian tubes while having xray images taken. The images will show the dye filling your uterus and passing through your fallopian tubes. The purpose of the dye is to show that there is no blockage in the fallopian tubes, and also confirms the shape of the uterus.

Generally the internet says if you don’t have a blockage, you should just experience some cramping. This was not the case for me…I like to think that I have a high pain tolerance but this was brutal. I would definitely describe the pain as cramping…but it was much more intense than I expected. The pain took my breath away… I would have tapped out if I could have. Very intense pain, for about 1 minute. 

The positive is that it is over very quickly. I was SURE I must have had an issue due to the amount of pain I felt. I was warned that I may have some spotting but what I experienced was much more than spotting..but only immediately after the test. After an initial heavy bleed, I had minimal spotting for a few days following the procedure.

Luckily, my results were normal and there was no evidence of blocked tubes or issues with my uterus. I do wish I had been warned about how painful an HSG could be, I don’t think anything could or should have been done differently but I would have saved myself from assuming that pain=blocked tube.

My intention is not to scare anyone, but I wish I had been more prepared. I was so overwhelmed by the unexpected pain that when I was done,  I sat in my car, called my sister, and cried. The moral of the story is that the experience of this very important test varies greatly person to person.

UPDATE:

I have had the pleasure of having a second HSG. Even though I had previously had a normal HSG in 2019, my new fertility provider requested we do the test in his facility. My first was done at a radiology center, the 2nd done at my fertility office. THE DIFFERENCE WAS NIGHT AND DAY. The tech doing my procedure this time talked me through the whole procedure, checking in on me and allowing breaks. She said that she does this procedure all day every day vs the radiology center I went to previously where the tech performs all types of xray procedures.

This time, it did show that my left tube was blocked. The tech asked me if we could push more dye through to try to unblock the tube..but made it very clear that it was my choice and warned me that it would be uncomfortable. I said to go for it, and had similar pain to my first HSG but only for seconds. She then “called it” and stated that my tube had spasmed and she did not want to put me in further discomfort.

This info really does not change my IVF plans..you don’t need fallopian tubes for IVF! However, they are looking for hydrosalpinx which essentially means the tube gets blocked with fluid that can drain down into the uterus causing implantation failure. Luckily this was not the case with me, so we left the tube alone.