HSG Procedure

My only advice when it comes to infertility testing is: DO NOT GOOGLE how painful something is.  You can google the procedure steps, the risks and the benefits, and what the results may mean.  But pain is something so subjective and different to everyone, that it is pointless to read other people's experiences!!!

I had myself freaked. out.  My OB was in a rush and told me nothing about the HSG (hysterosalpingogram) procedure.  I found it that it's a dye test to assess the size/shape of the uterus and the patency of the fallopian tubes.  I also found horror stories online!  I read all these stories on TTC (trying to conceive) forums about women being in more pain than labor and about having to have their cervixes dilated with metal rods and held open with clamps.  Clamps is such a terrifying word! 

Well, I was a nervous wreck for about a week before the test, and I was sweating like crazy this morning before I went to the hospital.  I never stress sweat.  I took 2 Ibuprofen like they had asked me to do, even though I'm not supposed to because of my kidneys.  I even caved and took my mom with me because I had read stories of women being in so much pain they passed out and weren't allowed to drive home.  So, we got to Outpatient Radiology and signed in.  I had to go to the lab and give a urine sample which came back negative for pregnancy.  I prefer to get BFNs (big fat negatives) in the privacy of my own home, so that was kind of a bummer.  Then, I was taken back to the dressing room where I had to disrobe from the waist down.  They said they would be preparing the instruments while I did this.  I waited for 15 minutes, which freaked me out because I wondered just how many instruments they had to prepare! 

Then, a nice radiology tech came and got me and took me into the x-ray room.  She thoroughly explained everything to me.  I told her I was one of "those" patients who had read about it on the internet.  Although she didn't outwardly do it, I could see she wanted to roll her eyes.  I'm the same way with my patients and families!  Then, I met the radiologist PA before I had to take off my scrub bottoms which was a very nice touch.  We got to shake hands before his hands went into the unknown.  I was also very nervous about having a male radiologist because I've only dealt with female OBs and NPs.  He was very nice and gentle, I have to say.

Here is the procedure for those who want to read on:

There were no stirrups.  I had to just keep my feet on the edges of the x-ray table.  The radiologist cleaned the outer area with betadine, then inserted the dreaded metal speculum.  He then used more betadine swabs to clean my cervix.  Up to this point, it was pretty much like a pelvic exam.  Then, the catheter was inserted.  Apparently I have a tilted cervix, so he had a little trouble getting the catheter through my cervix and up into my uterus.  At this point, I experienced mild cramping.  I gripped the sheet underneath me, but it was nothing to mention out loud.  The tip of the catheter (the balloon) was filled with air so that dye wouldn't leak back out.  This part caused a little more cramping, but still bearable.  There was just a lot of pressure-type feelings down there, not really pain.  The speculum was then removed.  He then injected the dye through the catheter which caused moderate cramping.  I laid on my back for about 10 seconds, then he had me rotate onto my left hip and then my right so that the dye would spill into both fallopian tubes.  I was able to do this with still moderate cramping.  The whole time, I was able to watch the dye flow on the monitor.  It was pretty cool!  The tech in the room helped the PA take pictures and she gave me emotional support when the cramping was at its worst.  I just took deep breaths and gripped the sheet.  Back to supine position, he deflated the balloon, pulled the catheter out and it was done!  They let me "catch my breath" for a minute, then he went over the images with me.  That was super nice because I don't have to wait for 2 weeks until my follow-up appointment to know preliminary results.  I then sat up slowly, didn't feel any reaction to the dye thankfully, (light-headed, dizzy, nauseous, etc.), hobbled in the bathroom and let a lot of dye drain out of me.  Then, I was given a hospital-sized pad (reminded me of when I was 12 before I could use tampons!), and sent back to the dressing room.

It was a very positive experience.  Everything was explained thoroughly, everyone was gentle and made sure I was okay throughout the whole procedure, and the cramps were nowhere near as bad as my Day 1 cramps.  Granted, I did not have a blockage.  If you have a blockage, I hear that's where the cramping can get severe. 

The results: I have a tilted uterus, which doesn't mean I can't get pregnant.  We just might have to be creative in positioning.  My left tube had somewhat of a polyp but dye was still able to flow through.  My right tube had narrowing, but again, dye was able to flow through.  So, there's no real reason why we shouldn't be able to get pregnant from my standpoint.  Yay!