When you’re exploring your fertility, your doctor might recommend a hysterosalpingogram (HSG) as part of your diagnostic testing. If you’ve never had one before, it’s normal to feel a little anxious about what the test involves and how to prepare for it. But don’t worry—with the right information and a little preparation, you’ll know exactly what to expect.
An HSG is a common and relatively simple procedure that provides important insights into your reproductive health. Let’s break down what an HSG is, why it’s done, and how you can get ready for the test.
What is an HSG?
A hysterosalpingogram (HSG) is an X-ray procedure used to examine your uterus and fallopian tubes. It helps your doctor check for blockages or abnormalities that could be affecting your ability to conceive. By using a special dye, an HSG allows your doctor to see the shape of your uterus and confirm whether your fallopian tubes are open, which is essential for the sperm to meet the egg.
Here’s what happens during an HSG:
1. A dye (contrast material) is gently injected through the cervix into your uterus.
2. As the dye fills your uterus and fallopian tubes, X-ray images are taken.
3. If the dye flows freely through the fallopian tubes, it indicates they are open. If it doesn’t, there may be a blockage or other issues that need further investigation.
4. The shape of your uterus is also examined to look for anything unusual, such as polyps, fibroids, or structural abnormalities.
Why Do You Need an HSG?
Your doctor may recommend an HSG if you’ve been trying to conceive and there are questions about whether your fallopian tubes are open or if there are any structural issues with your uterus that could impact fertility.
An HSG can help identify:
1. Blocked fallopian tubes
Blockages can prevent sperm from reaching the egg or stop a fertilized egg from moving into the uterus.
2. Uterine abnormalities
Structural issues like fibroids, polyps, scar tissue, or an abnormally shaped uterus can make it harder to conceive or increase the risk of miscarriage.
3. Adhesions
Scar tissue from previous surgeries, infections, or conditions like endometriosis can affect your fallopian tubes and uterus.
Getting an HSG helps your doctor determine the next steps in your fertility treatment plan. If blockages or abnormalities are detected, treatments such as surgery, IUI, or IVF may be recommended based on your unique situation.
How to Prepare for Your HSG
Preparing for an HSG is fairly straightforward, but there are a few things you can do to make the process more comfortable and ensure everything goes smoothly. Here’s what you need to know:
1. Schedule It at the Right Time in Your Cycle
The timing of your HSG is important. Your doctor will likely schedule the test between day 7 and day 10 of your menstrual cycle. This ensures that you’re no longer menstruating, but it’s early enough in your cycle to avoid the possibility of pregnancy.
2. Take Over-the-Counter Pain Relievers
Some women experience mild cramping during or after the procedure, similar to menstrual cramps. To help minimize discomfort, your doctor may recommend taking an over-the-counter pain reliever, like ibuprofen or acetaminophen, about 30-60 minutes before the procedure. This can help reduce cramping during the test and ease any post-procedure discomfort.
3. Eat Lightly
You don’t need to fast before an HSG, but some women feel more comfortable eating a light meal beforehand. Avoid heavy or greasy foods that might upset your stomach during the test.
4. Plan for Transportation if Needed
Most women are able to drive themselves home after the procedure, but if you’re concerned about cramping or feeling faint, you might want to arrange for someone to drive you just in case. If you’re feeling nervous, having a friend or partner accompany you can provide added comfort and support.
5. Bring a Pad
The dye used during the HSG may leak out after the procedure, and you may experience light spotting for a day or so. Bring a sanitary pad to wear afterward to stay comfortable. Your doctor’s office will likely provide one, but having your preferred pad on hand is a good idea.
6. Relaxation Techniques
If you’re feeling anxious about the test, practicing some relaxation techniques beforehand can help ease your nerves. Deep breathing exercises, guided meditation, or simply focusing on staying calm can make a big difference in how you feel going into the procedure.
What to Expect During the Procedure
An HSG is typically quick, lasting around 10 to 15 minutes, and is done in a radiology or fertility clinic. Here’s what you can expect step-by-step:
1. Positioning
You’ll lie on an exam table, similar to how you would for a pelvic exam or Pap smear. Your feet will be placed in stirrups.
2. Inserting the Dye
The doctor will insert a speculum into your vagina to keep it open, then clean your cervix. A small catheter is then gently inserted through your cervix into your uterus, and the dye is injected.
3. X-ray Imaging
As the dye flows through your uterus and fallopian tubes, X-ray images are taken. You may feel mild cramping as the dye moves through your reproductive system.
4. Post-Procedure
After the test, the speculum and catheter are removed, and you’ll be able to sit up and get dressed. Most women can resume normal activities right away, though some may prefer to rest if they experience cramping.
After the Procedure: What to Expect
After the HSG, you might have some mild cramping and light spotting for a day or two. This is completely normal and should resolve quickly. Most women feel fine afterward, but if you experience severe pain, heavy bleeding, or signs of infection (such as fever or foul-smelling discharge), contact your doctor right away.
In some cases, the HSG itself can improve fertility by flushing out minor blockages in the fallopian tubes. Some women report conceiving in the months following the procedure, even if no significant blockages were found.
The Results
Your doctor will usually review the X-ray images with you shortly after the procedure. If any blockages, scar tissue, or structural issues are found, they’ll discuss next steps and potential treatment options. If your tubes are open and your uterus looks healthy, your doctor may suggest other fertility treatments or tests to continue moving forward on your fertility journey.
Final Thoughts
While the idea of having an HSG can feel intimidating, the procedure is quick, minimally invasive, and provides valuable information about your reproductive health. With the right preparation and support, you’ll feel more comfortable and confident heading into the test.
At Prima, we’re here to support you through every step of your fertility journey, including diagnostic procedures like the HSG. Whether you’re just starting to explore your fertility or you’re already undergoing treatment, we’ve got you covered with expert advice, compassionate care, and 24/7 support.
