HSG - The Real Deal

Today, I have a hysterosalpingography which, aside from being hard to spell, is also hard to pronounce. Therefore, most women I know, including my fertility specialist's receptionist, refer to this as an HSG. That saves my fingers quite a bit, so I'll be referring to it as such from here on.

When you get an HSG, a doctor of radiology injects a radiation-sensitive into your uterus and fallopian tubes and then takes a picture. It's supposed to show whether there are blockages in your reproductive organs. Women's experiences with HSG vary greatly, so I thought I'd write about mine on the day of.

My appointment is in less than 3 hours from when I'm writing this part (I'll put a separation line in for after the procedure), so, there's no better time to talk about it!

Why do you need an HSG?

This is a pretty typical test for any woman who experiences trouble conceiving. There are a couple reasons for this that go beyond just checking the reproductive organs that I'll get into in just a second. I mean, we have male factor infertility (MFI), and our fertility specialist still recommends I get this. This seems to be a "just in case" situation.

When should you get an HSG?

As far as when you should get it, they recommend you get it done in the first half of your menstrual cycle because you'll have less uterine lining and it's less likely for it to interfere with attempts to conceive that cycle. Therefore, my clinic recommended I call the first day of my period (which luckily came on a Friday instead of the weekend), so they could schedule accordingly. My HSG is on CD7.

What preparations should you take for your HSG?

My clinic asked us to not have sex the day before, the day of, or the day after the test. I'm assuming that having sex before the test could introduce matter into the organs that could produce false results. And because they insert a catheter through the cervix to inject the dye, sex after the procedure increases the chance of infection. Better safe than sorry.

I've also been told to take ibuprofen before the procedure. This is the part that concerns me and why I wanted to write about it before I forgot. Women in my fertility groups describe the pain from this procedure with everything from, "mild pressure" to "I passed out from the pain."

My medical imaging department even requires me to have a driver to go in, and they might keep me up to 30 minutes, depending on how badly I react to the pain.

If there's anything I've learned from life, it's that no two people's pain sensitivities are the same. Nor are their reactions. So, though I'm prepared for pain, I'm not counting on passing out. But I am counting on a lot of pain because I have found that the more pain I think I'll have, the less a procedure seems to hurt. Hoping for the best. Planning for the worst. That's my family motto.

Will it help us get pregnant?

There are so many answers to this, but the short answer is yes. See, first of all, if you have any blockages, it will show you what's wrong. That means you can fix it or adapt to it. But the really cool thing is that HSG has shown a small increase in fertility for the four months after the procedure. No one really knows why, but if you google "HSG increase fertility", you'll find hundreds of stories about it. 

I swear every person who's ever had an HSG for fertility purposes tells me, "And then we got pregnant that month." 

So, I'm about to take some ibuprofen followed by a quick shower. And then I'll tell you all about my experience!

Well, the whole debacle took about two hours. I was told to arrive 15 minutes early and that the actual procedure would be another 15 minutes with a possible "recovery time" of 45 minutes more.

Traffic was good, so we ended up there 25 minutes early. I later found out that the imaging department was running about an hour behind. That meant that my ride had to leave because they had work starting and I had thought we would be done by now.

In short, I was supposed to be at the imaging department of the hospital at 12:10 and I walked out of the hospital at about 2:15. It was a long day.

So, the big question on everyone's mind is:

Did it hurt?

Before I answer that, I want to talk about pain. No two people experience pain the same way, and I feel like it would be a disservice to insinuate that my pain experience would be the same as anyone else's.

For me, the greatest pain I experienced was during the insertion of the catheter. I jumped at one point. If, like most women, you've had a pap smear, it felt like that, but if they just kept jabbing you with the stick. So, more painful than a pap smear, less painful than an IUD insertion (or removal).

Then he injected the dye. And that was uncomfortable. But it didn't really hurt. It was like when I hold my urine too long and it starts to hurt. So, all in all, I would say it didn't hurt like I was expecting.

I know some people will be curious what number that pain was on the pain scale would be, but I hate the typical pain scale:

For all the reasons that Allie Brosh of Hyperbole and a Half talks about. Two of those faces are people who are not in pain, and I have cried when I see a good refrigerator commercial, so they don't work out so great.

If I were to judge my pain on the Wong-Baker scale, I would have put it at a solid 6, because that's the face I made, but that's kind of a scary level of pain for most people.

Allie also developed her own pain scale that I feel correctly assesses pain:

Credit to Hyperbole and a Half

According to this scale, I'm more like a 3 which she describes as, "This is distressing.  I don't want this to be happening to me at all." That's even a little too strong.

So, we'll try one more scale:

Unknown creator

I'm also more of a 3 here. "It was kind of annoying."

Finally, I got the results today, and it seems everything's normal. The nurse was kind enough to "turn her back" while I took a quick video. This is what my uterus and Fallopian tubes look like as they fill up with liquid!