HSG test

March 27, 2009

This post may be interesting for someone who wants to know what to expect from her HSG test. I was grateful to read a some other first-hand experiences before I went. It sounds like the level of pain can vary from person to person. Some said they felt nothing, and one person with severe endometriosis said her HSG was the worst pain she had ever felt.  Endo can be very painful, so that’s pretty bad!

For me, the test was not nearly as bad as I expected — definitely uncomfortable but not awful. It got pretty painful at the end, just as the doctor was saying, “See, that doesn’t hurt, does it?” HA!  I had menstrual cramp-esque pain for a few hours afterward, but went straight to work without problems and felt normal by the afternoon.   I did have some odd (cervical?) discomfort for the next couple of days. I went running that afternoon, and suddenly felt a strange pain in the general region of my cervix. It hurt the rest of the night. The following day, it felt odd — not really painful, but sort of uncomfortable …  I guess I was aware of my cervix, which is not something I can usually feel when walking around, you know?  I was worried about it, but felt back to normal in two days. I had spotting for two days, then it stopped for a day, then started again. My doctor’s office said that was normal, and you can have some spotting for up to 10 days!

Here’s the play by play of the test:

My husband came with me to the radiology center.  He did not join me for the actual test (I don’t think it is allowed), but  sat in the waiting room reading the newspaper. We wanted him to be there in case I felt crummy afterward or the results looked bad, so I wouldn’t have to tell him on the phone or have a breakdown all by myself.  It was wonderful to know he was there, but as it turned out, I  could have survived on my own.

I had my test done at Washington Radiology Center, which does all kinds of x-rays, scans and other tests. (I went to their office on K St.)   I was very impressed with their efficiency, helpfulness and professionalism throughout the process — including my numerous insurance queries, calls to make (and change) the appointment and the exam itself.

I was (somewhat irrationally?) nervous about the exam, but was reassured as I got off the elevator and saw all the people in the waiting room that morning. It made me feel more normal. And I felt grateful that my infertility problems — as terrible as they seem to me — are not something worse. With the notable exception of my reproductive system, I am healthy. For that I am grateful.

They called me back right on time, and I changed into a hospital gown for the test. My mettle started to fade a bit when I saw the machine  — it was a daunting-looking huge metal table. But it wasn’t too bad.  The doctor inserted a speculum, which stayed there for the duration of the test. Lovely. He attempted to insert a catheter into my cervix, but it did not work at first, so he had to dilate my cervix first. The dilate and insertion was not pleasant — sort of a sharp pain.

Throughout all of this, the doctor was quite chatty — asking me all sorts of questions about where I live, what I do, etc. I think he was trying to keep my mind off the fact that he was inserting a lot of uncomfortable devices into my nether regions. But guess what? It didn’t work! I wanted to tell him, “Listen, let’s cut the small talk. Just let me be quiet and concentrate on breathing.” But …  I never say stuff like that and he was a really sweet man, so I, of course, obliged him with (very brief) answers to his questions.

Back to the test — once the lovely devices were in place, he inserted the dye, which flowed through my fallopian tubes fine, showing no blockage. Hooray! It was all very quick. I watched the process on the screen, but I was disappointed with what was actually visible. I was hoping I would get a clear pictures of my uterus and fallopian tubes and see how the whole thing worked. But (to me, at least) it basically looked like two lines, my fallopian tubes. I saw no uterus.  This was pretty disappointing, as I wanted the test to indicate whether or not there are any problems (endo?) in my uterus. I’m still not sure if it can do that — does anyone know?

When the doctor reviewed my results with me, I protested, “But you can’t even see my uterus!” He said he could see my uterine cavity and could tell it is the right shape (I think?), and that it looks good.  This is all obviously good news, but I don’t know how many other problems can be ruled out with a clear HSG. I guess I should just rejoice in not having blocked tubes!

The doctor told me  that people often have increased fertility for a few months after the exam and asked me to notify him if I get pregnant. That got my hopes up pretty high for this month — only to be dashed by a weird cycle. I’m on day 19 now and have seen no sign of fertile-quality cervical fluid or a clear temperature shift. Am I even ovulating? Sigh. I had such a lovely cycle last month!

An interesting side-note: the HSG doctor  knows my OBGYN in Fairfax! They used to work together at a hospital back in the day. This made me quite happy. He was a bit mystified why someone who lives and works in DC would go see a doctor way out in Fairfax. As I was lying on a metal table with a speculum between my legs at the time,  I did not particularly want to get into a long conversation about the Catholic practice, NFP and infertility. So I just said that “a friend” goes to this doctor and recommended him, and that we both really like him. This is mostly true, the “friends” being two women I have never met but whose blogs I enjoy, AYWH and Jeremiah 29:11. Thanks to you both!



  1. Hello! Just stumbled across your blog (I saw your comment on another blog) and realized that you mentioned me. Welcome to the blogging world! I’m SO GLAD that you were able to find your doctor through me and AYWH. It is such a special place and such a blessing. Glad to connect with you online. 🙂

  2. That’s really interesting. I have the same OB/GYN AND I went to the same radiology office (and I think they’re AWESOME. I posted about my HSG and my SHG). I imagine they didn’t ask me why I picked TFC because I live in Arlington – one office is East of me and one is West, so that kind of does make sense. I think.

    Anyway, I wanted to offer a totally inexpert answer to your question about endo. First of all, the HSG will probably see if there are obstructions in your uterus (in my case, it showed that there was a small something that turned out to be a polyp). But endo doesn’t really work like that – it basically is the endometrium growing OUTSIDE of your uterus (in addition to IN your uterus, where it belongs). I think that the uterus of a crazy-endo-ridden person would be fine, except for that andromeda whatsit thing I can’t remember the name of where the endo burrows into the uterine wall (i.e., deeper than it’s supposed to go). I have that. But I don’t think it should show in an HSG.

    The only real diagnosis for endo is if they cut a small hole in your stomach and insert a laparoscope to look around. Then they can see the endometrial tissue hanging out on your abdomen or intestines or bladder or whatever else, where it’s not supposed to be. Because this is a surgical procedure (albeit outpatient and local anaesthetic I believe), they don’t generally do it unless there is cause. There could be a few causes. (1) You have endo-type pain that is unmanageable. (2) You have a NaPro doctor and you are not responding to other IF treatment and your symptoms are consistent with endo. (3) An ultrasound reveals that you have ovarian cysts that might be endometrial.

    I am *not* a doctor, but endo is kind of my hobby, so that’s what I know. I should say, to be fair, that I had NO ENDO SYMPTOMS (except really bad cramps with menstruation, but I thought that was normal) until the day I went to the hospital with early appendicitis and the CT scan found an endometrial cyst the size of an orange (I had appendicitis, too. I self-diagnose really well!). I was young, granted, but my endo was already bad. So, it would not be safe to say that if you don’t have symptoms, you don’t have endo. But if you don’t have symptoms, that’s still good news, because it means that your body can take at least a little clomid or tamoxifen treatment before the pain becomes too bad to continue (those treatments exacerbate endometriosis, so women who are in a lot of pain have to choose between suspending the endo and accompanying pain, or regulating their hormones so they can get pregnant).

    One more thing: endo causes low progesterone (but it’s not the only thing that does). So, if you get that checked, maybe keep that in the back of your mind.

  3. Hey Misfit, thanks! You’re the best. I was so freaked out about my HSG before it happened, and now I wonder what the big deal was. So if anyone out there in the world is reading this before their HSG — don’t worry too much.

    I talked with Dr. B about the endo possibility last appointment. Note to self: blog about that appointment. I don’t have any “symptoms,” per se, but he noted that sometimes people have A LOT of pain and a tiny amount of endo, sometimes people have no pain and A LOT of endo. etc., etc.

    Anywhim, if I am not pregnant by Sept., I am supposed to go back in for a consult and laproscopy (sp?) with Dr L (forgot her name. I believe she is Jeremiah 29:11’s doctor).

    I also happen to have extremely high levels of progesterone, like *too* high, in my luteal phase. I have no idea is that is related. I need to blog about that too. Much to do.

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