HSG-The Good News and the Not As Good News

By:  Dr. Susan Wolf

HSG or the proper name “hysterosalpingogram” is likely to be one of the first tests that your doctor will order for you. I always warn patients about “googling” the test because you can get scared when you read about patient’s experiences. If you found this on your search, then it’s OK to read on. In general, it is the patients who had difficulty with the test who feel the need to post online and women who had no problems don’t feel the need to reach out to anyone.

An HSG is an X-ray dye test to evaluate the uterine cavity and fallopian tubes. It can determine if your fallopian tubes are open and if there are fibroids or polyps in the cavity of you uterus which might interfere with implantation of an embryo. It can also identify an abnormally shaped uterus which might increase the incidence of pregnancy loss.

The Good News!!!

Studies have shown that there is up to 30% increased pregnancy rates for the first 3 months after an HSG for couples with unexplained infertility. It is presumed that the dye itself flushes out debris (also known as “tubal goo”) and if that was all that was preventing pregnancy, you conceive within 3 months. It isn’t that the “flushing out” wears off after three months, it’s just that if the “tubal goo” was all that was keeping you from becoming pregnant, you will conceive within three months. So the really great thing is that an HSG can be therapeutic in addition to being diagnostic. Hurray!!

The Not As Good News

The test can be painful. Our practice is to offer pain medication for patients. I would encourage you to take it because it is hard to know ahead of time which person will need pain medication. Afterwards you may be crampy for the day, but the stronger pain actually lasts for about one minute or less during the procedure.

Always try and get a copy of your films at the time of the test so that your doctor can look at them. Usually the ordering physician only gets a report from the radiology facility and sometimes a picture is worth a thousand words.

Good luck.

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