HSG Test | All You Need to Know

Hysterosalpingography or HSG for short, is a test that allows medical professionals to see the inner workings of the reproductive system and mainly the uterus and fallopian tubes. Most people who are referred for one have either unsuccessfully been trying to fall pregnant and haven't or it's done as apart of a normal fertility workup. 

In our case, it was due to us not conceiving after our ectopic. They didn't presume anything was wrong however it was apart of the normal investigative process. Prior to booking my appointment, the consultant had us try Clomid which also was unsuccessful but we were positive because at least something was being done, even though the NHS itself had failed us so many times. 

In the lead up I read up on the process just so I had an understanding of what was happening as well as being able to gauge myself what they were seeing on the screen, naturally, I've become very distrusting of the NHS so I viewed it as the more knowledge I could gain prior, I would be more relaxed during. 

Off-the-bat I was aware that the NHS (in many cases) will tell you everything will be OK and that it won't hurt, or it's nothing more than a smear type of sensation. But, so many real-life cases told me otherwise. 

Speaking to people online over 95% of them stated it hurt a lot and in some cases, it hurt so badly that they had to stop so the HSG was never completed. On occasion a few mentioned ''they would never go through it again'' and for someone who is trying-to-conceive to say that, you have to realise that it must be more than a little painful. Most TTC will literally put their minds and bodies through anything in order to get that positive test and ultimately a baby in their arms. 

So what does the test entail? 

In my situation, I was on around day three of my periods but my blood doesn't flow all that well (not since my ectopic). I had asked prior if I would need to cancel and she said it was OK to come in. I went in and was made to sign waivers and various forms. Much like if you were having an operation. I was asked there and then ''are you allergic to iodine'' and my response was ''I'm not sure, I was always OK in science'' but let's be real here, no-one was enveloping themselves in that iodine so how was I really to know? 

I was asked if I had brought a urine sample, I hadn't as no-one advised I would need to. All I was told prior was that I must make sure I 100% was not pregnant and the recommendations were to not have sex from the point of your period to the HSG test itself. I was made to give a sample and not surprisingly it was negative. That would have absolutely been an Alanis Morrisette situation right there after a year or not getting pregnant, to have got a BFP on the morning of HSG, right? Keeping it real, I was slightly disappointed. 

They get you up on the bed, legs in stirrups, you know how it goes. In front of me was the actual screen so I knew I would be able to see my actual results in real-time, I'm not sure if this helped or made the anxiety set-in. There were three people in the room, the fertility nurse who was doing my test, the assistant nurse who was well, assisting, she was super fun, such a lovely lady and, my fertility consultant who literally gives me anxiety at the way he poorly manages fertility cases like ours.  

They let me know what was about to happen. The first was the speculum. I've never had problems with those, this ached a little (I've since found out that's my issue and not the HSG, I had a smear and it ached then also). They then advise that they will enter the catheter, and this is where I *was* worried. But nope, I felt nothing, I was actually worried they hadn't done it because I felt absolutely nothing. Then the fertility nurse advised they were infusing the iodine. I saw the uterus fill up slightly like a half-filled glass of wine, and then nothing. 

Panic set in quietly. 

The consultant advised her she hadn't used enough iodine and to re-do it. She tried another few times and it only increased to a full glass of wine type of image. 

He then decided to try again, naturally, I was trying to look calm, but the reality was I was panicked after the first incident of there not being enough iodine. The consultant himself tried and the same thing, the iodine was just retrograding back. So all-in-all they tried about four, five or six times. I honestly lost count. 

I had zero pain. I did wonder if it's because I was aching and had cramps from my menstrual cycle though but glad I didn't have the pain that was recorded from many others. 

While it seems positive. My consultant naturally is pretty blunt, inconsiderate sometimes and not very investigative. He noted I had a cervical erosion, asked if I'd had a smear - I hadn't. Then he stated that I must get one to check the erosion is an erosion and not the start of cervical cancer - cue the panic. Especially since I do get pain in my cervix and bleed a lot. He stated after the smear we would look at treatment for my cervix. 

I asked if there was a plan for my results and if anything could be done and he looked down and shrugged his shoulders and said I don't know. 

We made a follow-up, now me and hairy boy were well aware there were many things that they could do, quite easily for blocked tubes (we only have one tube). A few things include: 

 Vitamins and Supplements - Jury is out on these but you will find so many positive results from the use of antioxidants, serrapeptase, raspberry leaf and other hers. I will cover this in a separate post. 
 Fallopian Tube Flushing - Basically another HSG where they attempt to unblock using a water flush. 
 Fallopian tube cannulation - This is where they go into the tube using a thin wire in the hope of blocking it. It is usually done under day surgery and general anaesthetic, the success rate for 70% of people is around 20%. 

Smear booked and return appointment booked we went in only for ''our'' consultant to not be there. There was a completely new consultant who stated they wouldn't do anything other than referring us for IVF, but we would have to pay because were not eligible for it on the NHS. I may have stated that was unfair given that we meet all of the requirements barr one and, that if the NHS hadn't have buggered up last year, I'd still have my tube. He understood but said that IVF process is ''far easier'' than unblocking the tube and that he doesn't feel anyone in Scotland knew how to do that. 

I was frustrated. Especially since a few more investigative tests and/or HSG's were easy for them and far less costly than IVF. 

What I've since learned is that: 

Prior to an HSG you should be allergy tested at least 24 hours to check for iodine sensitivities. 
  You should not get an HSG done during your cycle. Mid-cycle increased the chances of false results as the uterus can contract closing off your tubes and giving a result showing a blockage. 
  You may not always feel pain. I believe that more pain is felt if the iodine reaches your tubes. Prepare in advance by taking a painkiller before you go in for your test. 
 You absolutely can get side-effects. Those include typically miscarriage or loss if you are pregnant prior to testing, bleeding (but this shouldn't be huge amounts), pain and cramping for a day but may be up to three or four days (I had mild cramps for around three days) and to boot, ended up with a cervix infection that required two-weeks of antibiotics. A cervix or uterus infection can cause kidney infections and if you're someone like me who is prone to kidney stones, the cramping may cause you more pain where your stones are located. 
 Even though some people have results that show a blockage, many are still able to fall pregnant. Even if they have only one tube. It's rarer of course but it does happen. 

I hope to cover more on this topic so if you have a different experience or have any questions please feel free to comment below, email me or Tweet me. This way I can ensure all of 'your' real-life questions and tips are covered. 

Elyse & Connor

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