If you are just beginning the fertility process at your clinic, one of the first tests that they will likely perform is a Hysterosalpingogram or HSG.  One of the least invasive of fertility testing procedures, the HSG gives you instant results.  It is typically used to see whether or not you have blocked tubes, but will also show uterus abnormalities and fibroids.

The exam is typically done at your fertility clinic or in the hospital’s surgical/surgery center.  It is a quick test, usually taking less than 15 minutes from beginning to end.  You will lie on your back and the doctor will inject contrast die into your uterus through your cervix while simultaneously taking an x-ray.  The contrast die will spread throughout your uterus or tubes, almost instantaneously showing whether there is a blockage.  In my case, I was able to watch the die as it spread.

Although your doctor will probably tell you that you “might” feel a “slight discomfort” during this procedure, the HSG experience is different for every woman.  I have a few friends who said it didn’t really bother them and one friend who said she came up off the table.  I guess I was somewhere in the middle of the road on that one.  It was somewhat painful for me, most likely because my tubes were blocked and that is said to add to the discomfort of the procedure.  I had actually taken a prescription strength Tylenol before my first HSG.  After having surgery to unblock one tube and remove the other, I had pain medication left over that they let me take before my second HSG.  There was one girl in my fertility support group that was terrified of the HSG and was actually prescribed one valium by her doctor before the procedure.

The HSG is a very important tool to help determine what your next course of action is in the fertility process.  If the HSG shows no abnormalities or blockages, then they can rule that out as a possible cause of your fertility problems.  If they do discover blockages in one or both of your tubes, then they will discuss your alternatives.  Basically you have two choices: either have surgery and attempt to unblock the tubes which will increase your probability of pregnancy or keep your tubes as is, which will obviously decrease the probability of pregnancy.  It is a personal decision and one that you need to discuss before proceeding.

There are some complications associated with having a blocked tube.  First of all, a blocked fallopian tube increases your risk of having an ectopic pregnancy.  Second of all, it is not recommended that you do an IUI or IVF procedure with a blocked tube as they can decrease your chances of success and can actually work against the procedure.  For instance, in an IUI, if your tube is blocked, then even if sperm is injected directly into the uterus, the chances that sperm and egg will meet are very slim since their means to meet is still blocked.  If you do an IVF procedure with a blocked tube, then the blocked tube can actually cause fluid to back up into the uterus, hindering implantation of an embryo.

If you do choose to have a procedure to unblock your tubes, your doctor should schedule an HSG after you have heeled from the surgery.  They need to make sure that everything looks good and clear after the surgery.  Again, this second HSG will help determine your next step in the fertility process.

There are two things that I learned from my HSG that I wanted to pass on to you.  First of all, do not go by yourself.  I went by myself–not that my husband wouldn’t have gone– I just insisted in going by myself because I thought it was going to be ok.  When it wasn’t ok, I wished he had been there.  Secondly, definitely take whatever pain medication your doctor offers before the procedure.  If you are one of the lucky ones that feels no pain or discomfort during the procedure, then great for you.  If not, then you will be better prepared for the discomfort.

All in all, the Hysterosalpingogram is a relatively easy procedure that gives you results while you are there.  For me, it was one of the most important tests done during our fertility journey as it gave us instant results and instant answers as to what was going on to prevent us from getting pregnant.  Although, slightly invasive, it is over quickly and you can to take the information you receive and move forward on your journey.

This entry was posted on Wednesday, March 8th, 2006 at 5:05 am and is filed under Fertility. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.