January 22, 2009

We scheduled the HSG one week after my period ended, but before I ovulated. It was important to make sure I finished my period but hadn’t ovulated-if there is ANY possibility you could be pregnant you SHOULD NOT have this procedure. We also did it on a day my husband could come with me. I was a bit nervous about it, yet excited at the same time. Anytime I have the opportunity to get a look into my body I am absolutely fascinated.

My ob/gyn told me this was an easy, minimally invasive procedure that would cause mild cramping. I have a retroverted uterus and endometriosis, with a history of painful periods, and thus was concerned about my pain level. She suggested I take 800mg ibuprofin an hour prior to the procedure to relax, but that I would not need anything stronger.

The HSG is scheduled as an outpatient procedure in the surgery center of the hospital. I checked into the hospital, was given my ID bracelet, and taken into the surgery center x-ray room. My husband was able to come with me—his first experience with me naked with a doctor! We entered the room and were greeted by the Nurse Assistant and the Radiologist (The procedure is performed by a radiologist, not an ob/gyn). I changed out of my clothes into a gown and laid down on the x-ray table. The Radiologist laid the lead apron over me and draped a lead gown over my husband as well. At this point, he explained the procedure to me.

  • I would scooch down to the edge of the table and bring feet up into a “frog leg” position. NO STIRRUPS! (I thought this was odd)
  • The Radiologist places a speculum in my vagina and visualizes the cervix.
  • A soft, thin catheter would be placed through the cervical opening into the uterine cavity and then a narrow metal cannula is inserted through the cervical opening.
  • Contrast dye would be slowly injected through the catheter into the uterine cavity. An x-ray picture would be taken as the uterine cavity is filling and then additional contrast is injected so that the tubes should fill and begin to spill into the abdominal cavity. (Additional x-rays are taken as this “fill and spill” occurs.)


I have to say, I was a bit mortified! Having the same female ob/gyn for 20 years, here I was on the table with a strange Radiologist up in my business with my husband watching. While the Radiologist was very professional, he did lack the grace and gentle nature of an ob/gyn. He did, however, talk me through every step of the procedure as he worked away. I appreciated that! He also allowed my husband to stay and hold my hand. I don’t know that my husband’s hand ended up liking that too much 🙂

He placed what may have been the largest speculum I have ever seen into my vagina, cleaned my cervix with betadine and inserted the catheter. This WAS NOT mild cramping. This felt more like the most painful menstrual cramps combined with the abdominal cramps that send you running to the toilet. It was a sharp, stabbing pain that literally made me see stars and put me in a cold sweat. For a moment, I thought I would pass out. I was thankful I was already lying down. According to the assistant, I turned several shades of pale.

After a brief moment of comfort, the Radiologist injected the contrast dye, so painful. At the same time, it was one of the coolest things I have ever seen. Directly above me was a TV screen where we could see the dye filling my uterine cavity and spilling out, then flowing into my fallopian tubes. FANTASTIC NEWS! Everything was clear, and functioning as it should. It was like nothing I had seen before, and rewarding to have instant feedback from the doctor. He removed the catheter, I got up slowly, had some water, and went to get dressed.


We were over the moon that everything was flowing smoothly, it meant we were clear to proceed with IUI. In that moment of happiness, the Radiologist came in to tell us he saw an abnormality in the shape of my uterus. He saw an indentation on the top, indicating there may be a cyst or fibroid growing on top. This was something he could not see on the HSG, and recommended an ultrasound prior to any fertility procedures. Ugh. I got dressed, we left.

This is a photo of a normal HSG



It does hurt, sorry. The doctors will all tell you this is a relatively pain-free procedure that should cause only mild cramping. From all the women I have spoken to, and from what I have experienced and read, IT IS NOT. Be prepared for that going in. I continued to have cramps for 3-4 hours after leaving the hospital, and found that resting with a heating pad was a great help.

Rolling over. You may have to roll on to one or both sides while the speculum and catheter are inside of you. This is not comfortable. I had read prior to my HSG that this meant something was wrong. I had to roll onto both sides, but ultimately there was no blockage. Don’t worry if you have to do this, maybe they are just trying to get a thorough look.

Bring a sanitary napkin with you. After the procedure you may have blood or dye that leaks out. I was somewhat of a rare case in how much I bled (I am told), but do know that most women have some spotting or dye that isn’t absorbed.

TALK TO YOUR DOCTOR! Ask them to tell you what they are doing as they are doing it. This can be a bit scary, but if you know what is going on, you will find it really interesting. It will also distract you a bit. Also, look at what is going on the TV. It is not often you get that kind of peek into your body, so check it out!

This is not routine for you. Don’t be afraid to tell the doctor and nurse if you are in pain. This is something they do everyday, and for them is no big deal. We don’t do this everyday.

Get up slowly. Again, from personal experience, and from speaking to others, many women feel faint after this procedure. Take it easy when you are getting up. Have some water. Make sure you have had something to eat before you go. Be sensible.