A lot of women in my fertility groups are asking what is a hysterosalpingogram (HSG). In this article I will dive into:
- Why doctors use an HSG
- Cost of an HSG and insurance
- How to prepare for an HSG
- What my experience was with an HSG
- Questions to ask your doctor
This information is provided to help those also struggling with infertility. This is in no way to be taken as medical advice, but information to be discussed with your doctor and see if this procedure would be right for your specific situation. Always seek medical advice before trying something new for your pre-pregnancy health.
Why doctors use an HSG?
An HSG is an x-ray of the fallopian tubes where the doctor inserts liquid into the uterus that flows through the fallopian tubes. The liquid containing iodine can be seen on the x-ray and the doctor can tell if a tube is blocked if the liquid does not reach the end of the fallopian tube. This is an important procedure because if your Fallopian tubes are blocked, no eggs are getting through!
If your tubes are open the doctor will see this on the x-ray machine by looking at where the liquid is following. If your fallopian tubes are blocked, the doctor will attempt to open them by tubal flushing. One of my tubes was blocked and when I was watching the doctor unblock the tube, it looked like the doctor was shoving the probe object down the fallopian tube to force it open.
I also had laparoscopic surgery where the doctor confirmed both of my tubes were open. This may be an option or your doctor may recommend IVF if the block cannot be resolved.
There are several medical studies in the US National Library of Medicine but I am going to highlight one. A study of 299 patients was evaluated and 25 were shown to be infertility (1). 70% of those patients were shown to have abnormalities on the HSG. The study showed that there was a high degree of infection and inflammation in these women (1). An HSG was vital for this study in detecting these abnormalities and thus concluded HSG should be made available to women with infertility (1).
Another topic I am going to write about soon is inflammation because it can lead to auto-immune diseases and even infertility.
Cost of an HSG
First, you should always call your insurance provider to provide you an estimate. If you are paying cash, ask the hospital or facility if there is a cash patient price. My doctor did my procedure at the hospital as an outpatient procedure.
The total cost billed to my insurance was $1112.00 and my portion was $103.00. Please remember that this is just for an HSG. If you elect to do something more invasive to open your fallopian tubes, like laparoscopic surgery you will pay much more.
The bill for my laparoscopic procedure was $36,000. My portion was around $2,000. IVF is even more expensive and if your insurance does not cover fertility then you will be paying thousands of dollars.
How to Prepare
My doctor told me the day of the procedure to take a painkiller thirty minutes prior to the procedure. I am not big on taking pain killers unless absolutely necessary, so I opted not to take any drugs.
Here are my recommendations:
- Take a pad because you will have bleeding of some kind and you do not want to rely on the facility to have one. Always be prepared.
- Wear comfortable clothes. You will have cramping following the procedure so I recommend not wearing tight pants.
- I would have someone take you and drive you home. It is great if your partner or parent can be there to support you through this journey.
Like I said above no pain killers for me. My procedure was completed in a hospital with my doctor and a specialist assisting him. This is an outpatient procedure so they will have you put on a hospital gown or something other than what you are wearing.
I went into a room that looked like an operating room where I laid on a table. At my head was the x-ray machine so throughout the procedure I was able to look back and see my doctor checking to see if my fallopian tubes were open. I did have one blocked tube and that was pretty cool to watch my doctor open it up.
During the procedure, I had to take deep breaths through the pain. It was not unbearable but definitely, pain that will hit you once the procedure starts. As the device moves through your body injecting the liquid, makes the pain worse.
The total procedure lasted twenty minutes. I will say the most pain happened on my ride home. I was equipped and had a pad with me, thank goodness because I did bleed a good amount following the procedure. For the procedure I wish I would have had someone drive me home that day because I am thirty minutes from the hospital. It was the longest ride home.
I have really bad periods, so I know extreme period pain. On my ride home I felt like I was having a really bad period and I just wanted to go home and curl up in a ball. Even with the pain I am still glad I did not take pain killers because it is important to feel the pain!
Questions to ask your doctor
- Ask if you fallopian tubes are open
- If they have pads at the facility or if you should bring your own
- Will your doctor be performing the procedure or someone else
- I recommend asking for a copy of the report for your records. I needed proof of an HSG for my IUI and I did not have a copy. It took 2 weeks to get a copy. Make sure you always keep copies of your records.
- If your tubes are closed and opened during the procedure, what is the likelihood of them closing again.
I hope you found this information useful. If you have other tips, please leave them in the comments for others having an HSG. We are in this together and need all the information we can get our hands-on.
- – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5672723/