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Everything You Ever Wanted To Know About An HSG

Everything You Ever Wanted To Know About An HSG


An HSG is also known as Hysterosalpingography is a procedure for women as an initial fertility test.

It is typically done before any type of fertility treatment takes place.

Undergoing an invasive procedure is scary, especially when it relates to your fertility.

But don’t worry I am here to walk you through every step of the procedure including…

-What it scans for and why you need it

-How to prepare

-What the experience is like

And why I am thankful I had an HSG done!

Disclosure: Bear in mind that some of the links in this post are affiliate links and if you click on them to make a purchase I will earn a commission. Keep in mind that I link these companies and their products because of their quality and not because of the commission I receive from your purchases. The decision is yours, and whether or not you decide to buy something is completely up to you.

What is an HSG?

HSG is short for Hysterosalpingography. It is a specialized x-ray to check for blocked fallopian tubes and the uterus.

Most fertility specialists will suggest an HSG for any woman who is transitioning into fertility treatment and who is having trouble conceiving.

This test specifically looks for

-Uterine fibroids


-Uterine polyps or tumors

-Blocked fallopian tubes (one or both)

For a successful pregnancy to occur, the sperm needs to swim through the uterus and into the fallopian tubes to meet a waiting egg.

If there are any scarring, blockage, or fibroids this can make the romantic meeting of egg and sperm much harder and sometimes impossible.

The procedure is conducted in the office during the first half of your menstrual cycle (after your period and before ovulation) and typically takes around 10 to 15 minutes.  

During the procedure, a doctor will have you lay on your back and a spectrum is inserted in the vagina.

From there the doctor will insert a thin tube (called a cannula) into your cervix.

Iodine is then pushed through the cannula and into the uterus.

Then, you watch the x-ray monitor! The iodine will (hopefully) work its way through the uterus, and up through the fallopian tubes.

While it is a nerve-wracking procedure for fertility, you will most likely receive an immediate result if your tubes are blocked.

If your doctor notices any abnormalities like scarring or fibroids, you may need to wait a few days to receive the results because the x-rays are sent to a radiologist.  

If a radiologist finds any abnormalities in the uterus or fallopian tubes, your fertility doctor will likely refer you for further testing and go over your options.

Although your fertility doctor always needs confirmation from a radiologist that your tubes are showing blockage or not, it is very easy to tell if they are blocked or not.

If your tubes are not blocked you will see the iodine spill out near your ovaries. Don’t worry the iodine is then absorbed by the body! 

But if they are partially or fully blocked, the iodine will build up or “balloon” near the blockage.

 Related Articles: An Overview Of The Cost Of Fertility Treatment

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How to prepare

Preparing for an HSG is relatively easy. Your doctor will schedule an appointment for your HSG sometime between the ending of your period and before ovulation.

This is done to ensure you are not pregnant, as an HSG could disrupt a pregnancy.

Of course, for every procedure, there are risks or side effects. Some of the side effects and risks of an HSG include:

-Allergic reaction to iodine (especially for those allergic to iodine, seafood, and other contrast dyes)

-Uterine cramping

-Vaginal bleeding

-Vaginal discharge (unpleasant-smelling)

-Uterine or fallopian tube infection

-Uterine injuries like perforation





Your doctor will discuss your unique situation and your own likelihood for all of the above risks and side effects.

Some doctors may prescribe an antibiotic to prevent possible infection.

It should be noted that an HSG is not recommended for women with Pelvic Inflammatory Disease (PID).

There are only two things required of you on the day of the procedure: 

-To remove all metal objects like jewelry (as it may interfere with the x-ray)

-To take Tylenol or other pain medication of your choosing 1 to 2 hours before the HSG procedure

What an HSG feel like

Before I dive into what an HSG feels like, let me tell you where I was in my infertility journey!

I did an HSG at around the 1 1/2 to 2-year mark of trying to conceive.

Before this, I had already received 3 months of TTC with Clomid, and 3 months of IUI’s with Clomid as well.

It was safe to say it was about time I checked for blockage in my tubes!

Now, since you’re here to know the complete extent of everything having to do with an HSG procedure, I am going to maintain my brutal honesty about how the procedure went for me!

Please be advised I am not telling you my personal experience to scare you and my HSG experience may be very different from what you may experience!

Before the procedure, my doctor told me to take over-the-counter pain medication. I took two 500mg tablets of extra-strength Tylenol.  

When your doctor tells you to take pain medication before the HSG, DO IT! Even if it is just a precaution and you end up not having any pain.

Although I am glad I took Tylenol, I feel like it did not help at all!

The procedure itself did not feel awkward at all, which I imagine it would for some women.

But I had already received three IUI’s before the HSG, so I did feel awkward at all to me.

Once the iodine was put through the cervix and made its way through the uterus and fallopian tubes, I started feeling a burning sensation.

That burning sensation kept traveling and I could feel the iodine moving through the tubes as I am watching it move through my uterus and tubes.

Many women will tell you that during an HSG it feels like cramping. However, it didn’t feel like cramping to me, it was like a severe burning!  

Although it only lasted for a minute or two, my fertility doctor could tell that I was in pain and kept reminding me it was almost done. It felt like it lasted a lot longer because of the burning sensation!

After I saw the iodine pass through my fallopian tubes and flow around the ovaries’, it was such a relief!

Not just because the procedure was over, but because I got immediate confirmation that my tubes were not blocked, nor did I have any scarring.  

I could then move forward with more fertility treatment.

Does it improve the chances of pregnancy?

Before having the HSG, I was hearing rumors on fertility forums that an HSG procedure may help increase your chances of pregnancy after the test is done.

Research has found that when an oil-based dye was used in an HSG compared to a water-based medium, pregnancy rates were increased in women with infertility.

While this is great news for you going into an HSG, research is still not sure why pregnancy rates increase after using an oil-based medium.

However, I do have a theory as to why it may increase your chances of fertility (of course this is not backed by science, just a simple theory!).

An HSG is also called a “tubal-flushing.” It could be that an oil-based dye compared to water is thicker and slower moving through your reproductive system allowing your uterus and fallopian tubes to be cleaned out better!

Final Thoughts

An HSG was one of the toughest steps I went through on my journey to conceive. I was walking into the procedure a nervous wreck and expecting the worst!  

After all, I already had previous failed cycles of fertility drugs and IUI’s.

But I was not expecting how painful the HSG would be. Again, I am not telling you this to scare you. Please, don’t let it scare you!

I am telling you the truth of what an HSG felt like to me. Your procedure may go completely different with no pain (at least I hope it will!).

Although the pain was great, I am beyond happy I got the procedure done!

I could have continued to waste money on further fertility treatment and find out I have a tubal blockage.

Plus, once confirming I did not have a blockage and everything looked great, it was a huge relief for my mental health.

When you have so many failed cycles, especially with fertility treatment, over time you do plan yourself and it only leads you to feel guilty about not getting pregnant.  

An HSG helped me to refocus my mind to stop planning myself and simply move forward with whatever treatment we had to do to get pregnant!

As you move forward with an HSG, I hope you receive good news and the pain is minimal for you! Sending lots of baby dust your way!


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