How to Survive Your HSG Procedure

Tonight’s episode is all about how to survive your HSG. Otherwise known as a hysterosalpingogram. That’s a big scary word so let’s break it down!

Hystero = uterus

Salpingo = tube

Gram = picture of

Hysterosalpingogram (HSG) is basically a picture of your fallopian tubes.

Before you start taking fertility pills like clomid please make sure to get your diagnosis before treatment.

Understand why you may not be getting pregnant. Get answers! I call this personalized fertility care. Don’t do the treatment before diagnosis.

So let’s talk about the HSG.

Some of the questions people ask me are, “what happens if they are blocked?”

Well, that’s why IVF was invented. One of the first pregnancies with IVF was actually in the fallopian tube. Even if you’re planning on doing IVF you still want to know if the fallopian tubes are blocked because even if that embryo is implanted in the uterus you’re at a higher chance for ectopic pregnancy.

There’s a condition called hydrosalpinx which means you have water/fluid in your fallopian tube. This is something you’d want to know beforehand as it would also decrease your chance of pregnancy and increase your chance of an ectopic pregnancy if you transfer in the presence of a hydrosalpinx.

So again to recap.

Why do we do the HSG? To check the tubes. The HSG can also help identify abnormalities inside the cavity of the uterus.

When do you do it? Every imaging center will have their own rules but most centers typically schedule the HSG between cycle days 7–10. Goal is to do it after bleeding is over and before ovulation.

What happens during the HSG?

Some people describe the HSG as one of the most painful procedures of their lives. I would rather people be prepared for what may happen ahead of time, so you don’t have unnecessary pain and discomfort.

A speculum goes inside of the vagina. A catheter then goes into the uterus. The doctor then pushes a radio-opaque dye into the uterus and watches that dye comes out of your fallopian tubes. This is done with a machine over your tummy. There’s a screen so it can be seen in real-time.

Does that sound painful? It is. Can you ever imagine a guy signing up for that without being under anesthesia? No. So why do we think a woman should do that without pain medication? I offer all of my patients antibiotics to prevent infection, one Tylenol with codeine and one valium 30 minutes before the procedure.

I do this so that my patients are not in pain or sharing horror stories with friends after the test. Anyone who goes through fertility treatment has enough hardship, the last thing that’s needed is another source of pain from the HSG.

Another question I get is, Who should go with me to the HSG?

It is always nice to have a fertility friend. If you are taking these drugs you should not be driving so you need a partner, friend, or family member to drive you safely and to be with you. If you are not taking these drugs then you are safe to drive.

The bottom line? Talk to your doctor about the pre-procedure medications. There’s no reason they can’t order you these medications just before the procedure so that you can have a very comfortable experience.

It’s also worth asking your doctor about the tilt of your uterus and if having a full bladder may help. If for example your doctors had a hard time doing the insemination procedures and now they’re doing the HSG, then it may be a good idea to go in with a full bladder so that it’s easier for them to get the catheter in.

So, in a nutshell, that’s how you can not just survive, but thrive through the HSG procedure! I hope these pro tips will make your experience a little better.

As always, please comment below or send me a note if you have any questions about this show or if you have a suggested topic for a future show.

You can also catch more of me and topics like this through The Egg Whisperer Show. The episodes are live-streamed on YouTube, Facebook, and Twitter and on Wednesdays at 7 PM PST. Subscribe to the podcast too!

Fertility Doctor, Reproductive Endocrinologist, Egg Whisperer:

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