Archive for July 18th, 2009

I’ve been struggling for some time now trying to get pregnant. And my friends are aware of that.

Lucky are those women [like bhem] wherein conceiving can be as easy as tossing out their contraception – whether they’re working on their first baby or their fourth. But for others [like me], reaching the goal of fertilization becomes a nightly chore, a mad mating dance that revolves around ovulation kits, specific sexual positions, and more commonly, a series of fertility tests to help pinpoint possible problems.

I’ve had several Transvaginal Ultrasounds done. I’ve had 5 or 6 cycles of clomiphene citrate already and recently, I’ve had my HSSG performed. I wasn’t able to provide you enough information about HSSG in my post two days ago because I just can’t find enough information about it. I’m going to give you some facts about HSG instead. HSG is somewhat similar to HSSG.

What is HSG?

HSG is an X-ray of the uterus and tubes performed in a radiology suite in order to diagnose a blockage of one or both tubes that may prevent the union of the sperm and egg [fertilization]. A special iodine-containing dye is injected through your cervix. It flows into the uterine cavity and through the tubes. If the tubes are unblocked, the dye will spill out of the tubes into the pelvis.

X-ray pictures will be taken during the procedure to give a permanent record of the condition of the tubes and the uterine cavity. The actual progress of the dye flowing through the tubes can be followed on a fluoroscopy TV monitor. X-ray pictures are available in a few minutes and can be examined by the radiologist, the gynecologist, and the patient. It is optimally performed within the first 12 days after the beginning of a normal menstrual period.

This procedure also gives a picture outline of the uterine cavity and may help in detecting abnormalities of the uterus that may cause infertility, repeated miscarriages, or abnormal vaginal bleeding. Occasionally, this procedure is ordered to diagnose causes of pelvic pain which originate inside the uterus. HSG is sometimes done a few months after the tubal surgery in order to give information about tubal patency.


To undergo an HSG, the patient first lies flat on an X-ray table. A vaginal speculum is then inserted (much like the speculum insertion during a Pap smear). The cervix is grasped with a holding instrument, and a small probe is inserted into the cervical canal. After injection of the liquid dye, the uterus may respond by having cramp-like contractions. Such cramps sometimes cause spasms in the tube.

Most patients do well when taking an 800 mg Motrin (ibuprofen) tablet 1 hour prior to the procedure. If you cannot take Motrin, or have excessive anxiety, your physician may prescribe other medications such as narcotics and/or sedatives [my OB prescribed Buscopan and Ponstan SF]. It is important that you do not drive a car during the 12 hours following the use of narcotics or anxiolytics. It is also important that a responsible adult accompany you to provide transportation and observation following the procedure, no matter which medications you have taken prior to the procedure.

What are the Complications and Side Effects of a Hysterosalpingogram?

A small percentage of patients may develop infection of the lining of the uterus, tubes or pelvis following this procedure. This is more common when the tubes have been damaged previously by infection or other causes. Infection in the tubes could lead to infertility, but the risk of infection is low (commonly estimated at 1%). If your HSG shows blockage of the tubes, you may be issued an antibiotic prescription to help prevent subsequent infection.

Allergic reactions are possible after injection of the iodine-based dye. During the procedure, a small amount of X-ray irradiation will be directed into the pelvic area and ovaries. The possibility of injury to an unfertilized or recently fertilized egg exists. Although the risk of causing a miscarriage or a malformed infant is not documented, the precise risk is unknown.

The potential risks of this procedure must be balanced against the information to be gained in evaluating the cause of the infertility.

What are the Alternatives to Hysterosalpingography?

The information gained from an HSG can also be obtained by laparoscopy and hysteroscopy. Information about the uterine cavity may also be gained by a saline contrast ultrasound.

Should I use Contraception during the Cycle I have my HSG?

The risks of abnormalities or problems related to the HSG are exceedingly rare. There is some evidence in the medical literature that conceptions rates may be greater in the cycles immediately following an HSG. You should consult your physician if you feel you may be pregnant.

After Having a Hysterosalpingogram:

1. There will be slight vaginal bleeding and/or discharge for a few days after the procedure. If bleeding increases or persists more than a few days, call your physician.
2. There may be moderate pain or cramping for several hours after the procedure. If the pain increases or persists overnight, call your physician.
3. Fever (temperature> 100.5 degrees F) with persistent pain may indicate the possibility of early infection. These symptoms should be reported to your physician or to the Emergency Room immediately.
4. Douching, vaginal intercourse, or use of tampons should be delayed until 48 hours after the procedure.
5. If you have any problems after the procedure, you should tell your physician.

Source: California IVF

Read Full Post »