HSG Test: What to Expect + How to Survive

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[Disclaimer: I am not a doctor or medical practitioner. Any medical information is strictly my opinion based on research and personal experience, and not to be taken as advice. Always seek the advice of a licensed physician for your medical needs. Read my full disclaimer here.]

The hysterosalpingogram (HSG) test is a live x-ray of your fallopian tubes. The purpose of the test is to make sure your fallopian tubes aren’t blocked. The test can also examine your uterus to see if there are any polyps, fibroid tissue, or scar tissue that could hinder your chances of conceiving. So, what should you expect and how do you survive it?

What to expect

You’ll first have to change into a hospital gown + then lay down on a table, similar to how you would during a gynecological exam.

The doctor will insert a thin tube full of dye all the way up through your cervix. (He will probably narrate this whole procedure.) I felt a little bit of pain. The dye is then injected into your uterus. I thought this would be when I would feel pain — but I didn’t even realize that he had injected it until I saw the dye on the x-ray screen! The doctor (and you–or at least I could anyway) can then watch on the live x-ray screen to see if the colored dye spills out into your fallopian tubes or not. If it does, it indicates that the fallopian tubes are open, and the harmless dye then spills out into your body to be reabsorbed. If the dye does not, then there may be a problem. The whole thing lasted no more than five minutes.

If your doctor just suggested that you do this test, here are my recommendations:

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Step 0: Make sure you actually need the test + it’s the one you want

When my doctor suggested this test, I assumed it was routine + wouldn’t cost a whole lot. (You can read more about that disaster in How I Unknowingly Spent Thousands on Fertility Testing. Yikes!) If I could go back in time, I would not do this test. Maybe by this point (after seeing another specialist) I would do it, but I think I did it way too early, when we hadn’t been TTC for long enough. After doing a little research after the test, I found out that there are a lot of variations of this test that can do a better job of testing for other things. (For instance, a laparoscopy, if you suspect you have endometriosis.) I wish I would’ve questioned my doctor about the test. (Not to mention asked about the cost…again, read my other post.)

Okay, now let’s assume you know you need the test:

Step 1: Ask your doctor questions in advance

Like I said, there are a lot of variations of this test. Ask which kind your doctor is ordering and why. There have also been studies done comparing the types of dye that are used — and some studies have shown that oil-based dye can increase your chances of conception for 3 months after the test. It’s worth educating yourself and asking questions before the test is done.

Step 2: Don’t panic

There are horror stories about this test. In reality, I found it to be only slightly more uncomfortable and painful than a typical gynecology check-up exam. I know everyone handles pain differently, but there’s really no need to psych yourself out here. If you’re really worried, my doctor recommended I take ibuprofen beforehand (I didn’t, and the recommendation itself made me think the pain was going to be worse than it was).

Step 3: Go by yourself

I didn’t really know what to expect, and my husband insisted on taking time off work to go with me (thanks for the support, D!). But really, it was unnecessary. He couldn’t go in the x-ray room, so he was literally in the waiting room the whole time. Probably not necessary, and I felt bad that he had wasted time off of work.

*Update: Okay, maybe this depends. I’ve read other stories of women who did go by themselves, and then had a weird reaction and felt sick after, and their recommendation would be “Take someone with you.” So your call.

Step 4: Be prepared for slight cramping/bleeding after

I did have slight cramping and light bleeding for a day or two after the test, but nothing major. Again, don’t psych yourself out…it was no big deal, but still worth mentioning that it’s normal.

And that’s it! A recap of the big takeaways: educate yourself before the test + if you decide you need it, don’t panic!

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